Experienced Customer Service Representative – Remote Medicare Appeal Support and Resolution Specialist at blithequark

Introduction to blithequark At blithequark, we are driven by a mission to empower better health outcomes through technology, services, and clinical expertise. Our goal is to innovate health solutions that deliver maximum value and impact, making a meaningful difference in the lives of individuals across the country. With a rallying cry of "Lead the Way," we invite talented and passionate individuals to join our team and take ownership of their work, embracing our company's mission and actively engaging in problem-solving to drive better outcomes. About the Role blithequark is seeking an experienced Customer Service Representative to join our growing team. As a Customer Service Representative, you will play a vital role in supporting the Medicare Appeal process by answering incoming telephone calls, resolving customer questions, complaints, and requests, and adhering to internal policies and procedures. This position is remote, offering you the flexibility to work from the comfort of your own home while making a significant impact in the lives of our customers. Key Responsibilities Develop and maintain working knowledge of internal policies, procedures, and services (both departmental and operational) to provide accurate and timely support to customers. Utilize automated systems to log and retrieve information, performing accurate and timely data entry of electronic faxes to ensure seamless communication. Receive inquiries from customers or providers by telephone, email, fax, or mail and communicate responses within required turnaround times, ensuring prompt and courteous service. Respond to telephone inquiries and complaints in a prompt, accurate, and courteous manner, following standard operating procedures to resolve issues efficiently. Interact with hospitals, physicians, beneficiaries, or other program recipients, serving as a liaison between the Review Supervisors and external providers to facilitate effective communication. Investigate and resolve or report customer problems, identifying and escalating difficult situations to the appropriate party to ensure timely resolution. Meet or exceed standards for call volume and service level per department guidelines, demonstrating a commitment to delivering exceptional customer service. Initiate files by collecting and entering demographic, provider, and procedure information into the system, maintaining accurate and up-to-date records. Maintain logs and documents disposition of incoming and outgoing calls, ensuring transparency and accountability in all interactions. Essential Qualifications High School diploma or equivalent required. 2+ years of customer service/telephone experience in a similar call center environment and/or industry, demonstrating a strong ability to communicate effectively with team members and external customers. Ability to research and resolve issues related to Medicaid program and service eligibility, with a strong understanding of internal policies and procedures. Preferred Qualifications/Experience Previous experience in the medical office or other medical setting preferred, with a general knowledge of eligibility verification (Medicaid eligibility and program requirements for specific program of focus). Knowledge of CPT and HCPCS codes preferred, with PC proficiency to include Microsoft Office Suite. Experience with Microsoft programs and automated systems, with a strong ability to learn and adapt to new technologies. Career Growth Opportunities and Learning Benefits At blithequark, we are committed to the growth and development of our employees. As a Customer Service Representative, you will have access to ongoing training and development opportunities, enabling you to enhance your skills and knowledge and advance your career. Our team is dedicated to supporting your success, providing you with the tools and resources you need to excel in your role and make a meaningful impact in the lives of our customers. Work Environment and Company Culture blithequark is a dynamic and supportive work environment, where talented and passionate individuals come together to drive better health outcomes. Our company culture is built on a foundation of respect, empathy, and compassion, with a strong commitment to diversity, equity, and inclusion. As a remote employee, you will be part of a virtual team that is connected by a shared mission and values, with opportunities to collaborate and engage with colleagues across the country. Compensation, Perks, and Benefits blithequark offers a competitive compensation package, with a pay range of $15.85 - $18.20 per hour, depending on experience and skill level. Our benefits package includes comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. We are committed to providing our employees with a rewarding and supportive work environment, with opportunities to grow and develop their careers. Conclusion If you are a motivated and compassionate individual with a passion for delivering exceptional customer service, we invite you to apply for the Customer Service Representative role at blithequark. As a member of our team, you will have the opportunity to make a meaningful difference in the lives of our customers, while advancing your career and growing with a dynamic and supportive organization. Apply today to join our team and take the first step towards a rewarding and challenging career in customer service! Apply for this job