Experienced Full Stack Customer Service Representative – Healthcare Industry at Blithequark

Remote, USA Full-time
Join Blithequark: Where Compassion Meets Innovation in Healthcare Blithequark is a leading healthcare company dedicated to delivering exceptional patient experiences and innovative solutions. We're on a mission to transform the healthcare landscape by providing personalized, accessible, and affordable care. Our team is driven by a shared purpose: to put the heart into every aspect of healthcare. We're seeking a talented and compassionate Customer Service Representative to join our team and make a meaningful impact on the lives of our members. About the Role As a Customer Service Representative at Blithequark, you will be the face of our organization, influencing the service experience of our members through phone, web, or written correspondence. You will handle complex customer inquiries, resolve issues, and provide guidance on our plans, tools, and resources. Your goal will be to build trust, empathy, and personalized relationships with our members, ensuring they receive the support they need to achieve their best health. Key Responsibilities: Respond to questions and resolve issues from members, providers, and plan sponsors via phone, letters, or online correspondence. Escalate emergencies to the appropriate staff and record/track contacts with members, providers, and plan sponsors. Guide members through their plan benefits, Blithequark policies, and procedures, while being aware of resources to comply with regulatory requirements. Build personal connections with members by understanding and engaging with their unique needs and preferences. Take ownership of understanding member needs by establishing trusting and caring relationships. Anticipate member needs and provide relevant information to address unasked questions. Utilize customer service tools and systems to make informed decisions and resolve member issues. Explain member limitations according to contract and process claims references, new case handoffs, and other related tasks. Educate providers on self-service options and assist with credentialing and re-credentialing issues. Handle incoming requests for information and respond to litigation and claims-related inquiries. Participate in the preparation of protest pattern reports and integrate claims data for client reviews. Determine clinical needs, relevant coverage policies, and check member plan eligibility. Perform reviews of member claims history to ensure accurate tracking of benefit maximums and coinsurance/deductible. Provide financial data support as needed. Utilize system tools and resources to generate quality letters and reports. Requirements and Qualifications: Essential Qualifications: Bachelor's degree in a related field. Previous customer service experience in a call center or retail environment, preferably in healthcare. Strong communication and interpersonal skills. Ability to multitask and work in a fast-paced environment. Proficiency in Microsoft Office and Outlook. Accurate and detailed work style with high levels of productivity. Excellent problem-solving and critical thinking skills. Empathy and compassion when interacting with members. Preferred Qualifications: Experience with healthcare terminology and concepts. Familiarity with customer service software and systems. Previous experience in a healthcare setting. Certification in customer service or a related field. What We Offer: At Blithequark, we're committed to creating a work environment that supports the well-being of our employees. We offer: Competitive hourly rate of $30-$41. Comprehensive benefits package, including medical, dental, and vision coverage. 401(k) retirement savings plan and employee stock purchase plan. Fully paid term life insurance and short-term and long-term disability benefits. Wellness programs, education assistance, and free development courses. CVS store discounts and programs with participating partners. Paid time off (PTO) and vacation pay. Opportunities for career growth and professional development. Our Culture: At Blithequark, we value: Compassion and empathy in every interaction. Innovation and creativity in solving complex problems. Collaboration and teamwork across departments. Diversity, equity, and inclusion in the workplace. Continuous learning and professional growth. How to Apply: If you're passionate about delivering exceptional customer experiences and making a difference in healthcare, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, to join our team at Blithequark. Don't miss this chance to be part of a dynamic team that's shaping the future of healthcare. Apply now and start your journey with Blithequark! Apply for this job
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