Experienced Customer Service Representative - Remote Opportunity with blithequark

Join blithequark and Make a Difference in Healthcare At blithequark, we're driven by a singular, clear purpose: to carry our heart to each moment of your health. Our mission is to deliver enhanced, human-driven healthcare in a rapidly changing world. With a focus on putting our heart into caring for our members and communities, we're seeking a dedicated Customer Service Representative to join our team. About the Role As a Customer Service Representative at blithequark, you'll be the face of our organization, influencing the member experience through your interactions via phone, web, or written correspondence. You'll engage with, counsel, and educate members based on their unique needs, preferences, and understanding of blithequark plans, tools, and resources. This is a 24/7 customer support inbound call operation, requiring flexibility to work any shift, including weekends and holidays. Key Responsibilities Respond to questions and resolve issues based on calls/letters from members, providers, and plan sponsors. Escalate emergencies to appropriate staff and maintain accurate records of contacts with members, providers, and plan sponsors. Guide members through their plan benefits, blithequark policies, and procedures, ensuring compliance with regulatory guidelines. Create a personal connection with members by understanding and engaging them to support their best health. Anticipate member needs and provide relevant information to address unasked questions. Utilize customer service skills to make informed decisions and resolve member issues. Explain member entitlements according to contract and process claim references, new case handoffs, and other requests. Educate providers on self-service options and assist with credentialing and re-credentialing issues. Respond to demands received from blithequark's Regulation Record Department regarding litigation and claims. Determine clinical needs, relevant coverage policies, and verify member eligibility. Handle incoming requests for appeals and pre-approvals not handled by Clinical Case Management. Perform review of member claim history to ensure accurate tracking of benefit maximums and coinsurance/deductible. Utilize relevant system tools and resources to generate quality letters and calculation sheets. Essential Qualifications To succeed in this role, you'll need: Customer service experience in a transaction-based environment, such as a call center or retail store. Ability to multitask and efficiently achieve productivity standards. Understanding of medical terminology. Proficient oral and written communication skills. Proficiency with Microsoft Word and Outlook. Ability to maintain accuracy and production standards. Strong problem-solving skills and attention to detail. Preferred Qualifications While not required, the following qualifications are highly valued: Bachelor's degree. Experience in a production environment. Technical skills and ability to learn new systems and tools. What We Offer At blithequark, we're committed to providing a comprehensive benefits package and a supportive work environment. As a member of our team, you'll enjoy: A competitive hourly rate of $30-$41 per hour. A full range of medical, dental, and vision benefits. A 401(k) retirement savings plan and Employee Stock Purchase Plan. Term life insurance, short-term and long-term disability benefits. Various wellness programs, education assistance, and free improvement courses. Paid Time Off (PTO) and holiday pay, as well as paid holidays throughout the calendar year. Career Growth and Development At blithequark, we're dedicated to helping our employees grow and develop in their careers. As a Customer Service Representative, you'll have opportunities to: Develop your skills and expertise in a dynamic and supportive environment. Take on new challenges and responsibilities as you grow in your role. Participate in training and development programs to enhance your knowledge and skills. Our Culture At blithequark, we're passionate about putting our heart into caring for our members and communities. Our culture is built on a foundation of empathy, compassion, and a commitment to delivering exceptional customer service. We're a diverse and inclusive organization that values the unique perspectives and experiences of our employees. Preparing for Success To help you prepare for your interview, here are some common questions and tips: Be ready to talk about your experience and skills relevant to the role. Highlight your strengths and the qualities that make you a strong candidate. Be honest about your weaknesses and how you're working to improve them. Show your passion for delivering exceptional customer service and your ability to work in a fast-paced environment. Conclusion If you're a motivated and compassionate professional looking for a challenging and rewarding role, we encourage you to apply for this Customer Service Representative position at blithequark. Join our team and make a difference in the lives of our members. Apply now and take the first step in a fulfilling career with blithequark. Apply Now! Apply for this job