**Experienced Customer Service Representative – Work From Home Opportunity at blithequark**

Are you a customer service enthusiast with a passion for delivering exceptional experiences? Do you thrive in fast-paced environments where no two interactions are ever the same? If so, we invite you to join blithequark as an Experienced Customer Service Representative – Work From Home Opportunity. As a key member of our team, you will play a vital role in providing top-notch support to our customers, ensuring their needs are met, and exceeding their expectations. **About blithequark** At blithequark, we are committed to revolutionizing the healthcare industry by delivering personalized, convenient, and affordable solutions. Our purpose is to bring our heart to every moment of your health, and we strive to make a meaningful impact on the lives of our customers. With a culture that values innovation, empathy, and collaboration, we empower our employees to be the best versions of themselves and make a difference in the world. **Our Heart At Work Behaviors** Our Heart At Work Behaviors are the foundation of our culture, guiding us to deliver exceptional experiences and make a lasting impact. These behaviors include: * **Empathy**: We understand and acknowledge the perspectives of our customers, colleagues, and partners. * **Innovation**: We encourage creativity, experimentation, and calculated risk-taking to drive growth and improvement. * **Collaboration**: We work together as a team, sharing knowledge, expertise, and resources to achieve common goals. * **Accountability**: We take ownership of our actions, decisions, and outcomes, ensuring we meet our commitments and exceed expectations. **Job Summary** As an Experienced Customer Service Representative – Work From Home Opportunity, you will be responsible for providing exceptional support to our customers through various communication channels. Your primary duties will include: * **Maintaining a positive, empathetic, and professional attitude** toward customers at all times. * **Responding promptly to customer inquiries** and resolving issues in a timely and efficient manner. * **Communicating with customers** through various channels, including phone, email, and chat. * **Acknowledging and resolving customer complaints** in a fair and respectful manner. * **Knowing our products inside and out** to answer questions and provide accurate information. * **Processing orders, forms, applications, and requests** with accuracy and attention to detail. * **Keeping records of customer interactions, transactions, comments, and complaints** to ensure seamless communication and resolution. * **Communicating and coordinating with colleagues** as necessary to ensure effective teamwork and collaboration. * **Providing feedback on the efficiency of the customer service process** to drive continuous improvement. **Responsibilities** * Answer questions and resolve issues based on phone calls/letters from members, providers, and plan sponsors. * Triage resulting rework to appropriate staff. * Provide excellent customer services for high-volume inbound provider calls for the Claims Inquiry/Claims Research team. * Extensive claims research on multiple platforms to assist providers with payment questions. * Provide the customer with related information to answer unasked questions, e.g., additional plan details, benefit plan details, member self-service tools, etc. * Use customer service threshold framework to make financial decisions to resolve member issues. * Explain member's rights and responsibilities in accordance with contract. * Process claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance, and appeals (member/provider) via target system. * Educate & assist providers on our self-service options. * Assist providers with credentialing and re-credentialing and contracting questions and issues. * Assist in compiling claim data for customer audits. * Determine medical necessity, applicable coverage provisions, and verify member plan eligibility relating to incoming correspondence and internal referrals. **Requirements** * **Must live in the state of Oklahoma full-time**. * **Familiarity with Microsoft Office products**. * **Experience in highly transactional call center environment**. * **Excellent customer service and critical thinking**. * **High-speed internet access (25 mbps or higher) and consistent connection**. * **Work location must be set up with a direct connection to the router (NOT Wi-Fi)**. We provide a 6 ½ foot long ethernet cord, if the distance is further, you will be required to provide your own ethernet cable. **Education** * **High School diploma or GED equivalent**. **Work Schedule** * **Must be able to attend 4 weeks of training (virtual) between the hours of 8-5 CST**. * **After training, the permanent schedule is an Monday-Friday and can start as early as 7 am CST and end as late as 7 pm CST**. **What We Offer** * **Competitive compensation and benefits package**. * **Opportunities for career growth and professional development**. * **Collaborative and dynamic work environment**. * **Recognition and rewards for outstanding performance**. * **Flexible work arrangements, including work-from-home options**. **How to Apply** If you are a motivated and customer-focused individual who is passionate about delivering exceptional experiences, we encourage you to apply for this exciting opportunity. Please visit our website to submit your application and join our team at blithequark. Apply for this job