Experienced Customer Service Representative – Remote Full-Time Opportunity with blithequark at $30/Hour

Introduction to blithequark At blithequark, we share a singular, clear purpose: Carrying our heart to each snapshot of your wellbeing. This purpose directs our obligation to deliver enhanced human-driven healthcare for a quickly impacting world. Our motivation sends an individual message that how we deliver our services is equally as important as what we deliver. We are committed to making healthcare more private, convenient, and affordable for all. Job Overview We are seeking an experienced Customer Service Representative to join our team at blithequark. As the face of our company, you will influence individuals' service experience by handling customer care requests and issues via phone, web, or written correspondence. Your role will be to engage, consult, and educate individuals based on their unique needs, preferences, and understanding of blithequark plans, tools, and assets to guide them along a pathway to care. Key Responsibilities Respond to questions and resolve issues resulting from calls/letters from individuals, suppliers, and plan sponsors. Emergency situations are escalated to appropriate staff, and records and tracks contacts with individuals, suppliers, and plan sponsors. Guide the member through their individual plan of benefits, blithequark policy, and procedures, as well as being aware of resources to comply with any regulatory requirements. Make a personal connection with our members by understanding and engaging the member to the fullest to support our members' best health. Take ownership to understand the member's needs by building a trusting and caring relationship with the member completely. Anticipate customer needs and provide the customer with relevant information to address the unasked questions, such as extra plan details, benefit plan details, member self-service tools, etc. Utilize customer support limit system to make financial decisions to resolve member issues. Explain member's limitations as per contract. Process claim referrals, new case handoffs, nurse reviews, complaints (member/supplier), and appeals (member/supplier) via target system. Educate suppliers on our self-service options and help suppliers with credentialing and re-credentialing issues. Answer demands received from blithequark's Regulation Record Place regarding litigation and claims, and handle broad document review demands. Aid in the preparation of complaint pattern reports and assist with incorporating claim data for customer reviews. Determine clinical needs, relevant coverage policies, and verify member plan eligibility related to incoming communication and internal referrals. Handle incoming requests for authorizations and pre-approvals not handled by Clinical Case Management. Perform a review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible. Perform financial data entry as needed. Utilize relevant system tools and resources to create quality letters and spreadsheets in response to requests received. Essential Qualifications Bachelor's degree required. Customer service experience in a transaction-based environment, such as a call center or retail store, is preferred, demonstrating the ability to be empathetic and compassionate. Experience in a production environment. Ability to multitask to efficiently accomplish tasks. Understanding of medical terminology. Effective oral and written communication skills. Proficient with Microsoft Word and Outlook. Ability to maintain accuracy and production standards. Interpersonal skills. Technical skills. Problem-solving abilities. Attention to detail and accuracy. Preferred Qualifications Previous experience in a customer-facing role, preferably in the healthcare industry. Knowledge of healthcare plans, policies, and procedures. Experience with customer relationship management (CRM) software. Strong analytical and problem-solving skills. Career Growth Opportunities and Learning Benefits At blithequark, we are committed to the growth and development of our employees. We offer various training programs, workshops, and online courses to enhance your skills and knowledge. Our goal is to provide you with the tools and resources needed to succeed in your role and advance in your career. Work Environment and Company Culture Our company culture is built on the principles of empathy, compassion, and excellence. We strive to create a work environment that is supportive, inclusive, and respectful of all employees. We believe in recognizing and rewarding outstanding performance, and we offer various employee recognition programs to show our appreciation for your hard work and dedication. Compensation, Perks, and Benefits We offer a competitive salary range of $30-$41 per hour, depending on experience. In addition to your compensation, you will enjoy the benefits of working for an organization that truly cares about its employees and the communities we serve. Our benefits package includes: Medical, dental, and vision benefits. 401(k) retirement savings plan. Employee Stock Purchase Plan. Term life insurance. Short-term and long-term disability benefits. Wellness programs. Education assistance. Free development courses. Discount programs with participating partners. Paid time off (PTO) or vacation pay. Paid holidays throughout the calendar year. Conclusion If you are a motivated and compassionate individual who is passionate about delivering exceptional customer service, we encourage you to apply for this exciting opportunity to join our team at blithequark. As a Customer Service Representative, you will play a critical role in shaping the customer experience and making a positive impact on the lives of our members. Don't miss out on this chance to be part of a dynamic and growing organization that truly cares about its employees and the communities we serve. Apply for this job