Experienced Customer Service Representative for National Remote Opportunities - Delivering Exceptional Healthcare Support and Solutions

Welcome to blithequark

At blithequark, we're dedicated to making a positive impact on the lives of millions of people across the United States. As a leader in the healthcare industry, we're committed to providing high-quality, consumer-oriented health benefit plans that create a better healthcare experience for our members. Our goal is to deliver exceptional care, lower costs, and greater access to healthcare services. If you're passionate about helping others and making a difference in your community, we invite you to join our team as a Customer Service Representative.

About the Role

In this critical role, you'll be the primary point of contact for our members, providing exceptional customer service and support to address their questions, concerns, and needs. You'll be responsible for responding to incoming phone calls, resolving issues, and providing timely and accurate information to our members. Your compassion, empathy, and excellent communication skills will enable you to build strong relationships with our members and provide personalized support to ensure their needs are met.

Key Responsibilities

• Answer incoming phone calls from customers and identify the type of assistance needed, such as benefit and eligibility, billing and payments, authorizations for treatment, and explanation of benefits (EOBs)
• Ask appropriate questions and listen actively to identify specific questions or issues, documenting required information in computer systems
• Own problems through to resolution on behalf of the customer in real-time or through comprehensive and timely follow-up with the member
• Review and research incoming healthcare claims from members and providers, navigating multiple computer systems and platforms to verify data and information necessary for processing
• Ensure that the proper benefits are applied to each claim, using the appropriate processes and procedures, such as claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents, and certificates
• Communicate and collaborate with members and providers to resolve issues, using clear and simple language to ensure understanding
• Meet performance goals established for the position in areas such as efficiency, accuracy, quality, member satisfaction, and attendance

Requirements and Qualifications

To be successful in this role, you'll need to possess a combination of skills, experience, and personal qualities that enable you to provide exceptional customer service and support. These include:

Essential Qualifications

• High School Diploma/GED or equivalent experience
• 1 year of prior experience in a call center setting
• 1 year of experience in a customer service role
• Experience working in the healthcare and health insurance industry
• Experience with Medical Terminology
• Experience working in a metric-driven work environment
• Ability to work any 8-hour shift between 8:00 AM - 4:30 PM CST, Monday - Friday, including flexibility to work occasional overtime based on business need
• Must be 18 years of age or older

Preferred Qualifications

• Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner, identifying and exceeding customer expectations
• Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests, and identify the current and future needs of the member
• Proficient problem-solving approach to quickly assess the current state and formulate recommendations
• Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon
• Flexibility to customize approach to meet all types of member communication styles and personalities
• Proficient conflict management skills to include the ability to resolve issues in a stressful situation and demonstrating personal resilience

What We Offer

At blithequark, we're committed to providing our employees with a comprehensive benefits package, opportunities for career growth and development, and a supportive work environment that enables them to thrive. Some of the benefits you can expect include:

• Competitive salary and benefits package
• Opportunities for career growth and advancement
• Comprehensive training and development programs
• Flexible work arrangements, including telecommuting options
• Recognition and reward programs for outstanding performance
• A dynamic and supportive work environment that values diversity and inclusion

Work Environment and Culture

At blithequark, we're proud of our diverse and inclusive work environment, where everyone has the opportunity to contribute and grow. We believe that our employees are our greatest asset, and we're committed to providing a workplace that is supportive, flexible, and empowering. Some of the highlights of our work environment and culture include:

• A collaborative and team-oriented approach to work
• A culture that values diversity, equity, and inclusion
• Opportunities for professional growth and development
• A comprehensive benefits package and competitive salary
• A dynamic and supportive work environment that recognizes and rewards outstanding performance

How to Apply

If you're passionate about delivering exceptional customer service and making a positive impact on the lives of others, we invite you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, to be considered for this role. We look forward to hearing from you!

Equal Employment Opportunity

blithequark is an Equal Employment Opportunity/Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

Join Our Team

At blithequark, we're committed to making a positive impact on the lives of millions of people across the United States. If you're passionate about delivering exceptional customer service, making a difference in your community, and growing your career with a dynamic and supportive organization, we invite you to join our team. Apply today and take the first step towards a rewarding and challenging career with blithequark!