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: Carrying our heart to each moment of your health. Our mission is to deliver enhanced, human-driven healthcare for a rapidly changing world. As a key member of our team, you'll be empowered to play a vital role in transforming our culture and accelerating our ability to grow and deliver solutions that make healthcare more personal, convenient, and affordable.

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 with individuals, providers, and plan sponsors. You'll handle customer inquiries and issues via phone, web, or written correspondence, providing personalized support and guidance to help members navigate their benefits and access the care they need.

Key Responsibilities

• Respond to questions and resolve issues from members, providers, and plan sponsors in a timely and professional manner.
• Engage with members to understand their unique needs and preferences, providing tailored support and guidance to help them achieve their health goals.
• Utilize knowledge of blithequark plans, tools, and resources to educate members on their benefits and available services.
• Process claims references, new case handoffs, nurture reviews, complaints, and requests via our target system.
• Assist providers with credentialing and re-credentialing issues, and educate them on our self-service options.
• Respond to demands from blithequark's Regulation Record Department regarding litigation and claims.
• Participate in the preparation of complaint pattern reports and help integrate claim data for client reviews.
• Determine clinical needs, relevant coverage policies, and verify member plan eligibility in response to incoming correspondence and internal referrals.
• 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/or coinsurance/deductible.
• Provide financial data support as needed.
• Utilize relevant system tools and resources to generate quality letters and calculation sheets in response to requests received.

Essential Qualifications

To succeed in this role, you'll need:

• A Bachelor's degree from an accredited institution.
• Customer service experience in a transactional environment, such as a call center or retail store.
• Excellent communication and interpersonal skills, with the ability to empathize with members and provide personalized support.
• Strong problem-solving skills, with the ability to analyze complex issues and provide effective solutions.
• Proficiency in Microsoft Word and Outlook.
• Ability to multitask and prioritize tasks effectively in a fast-paced environment.
• Strong technical skills, with the ability to learn and adapt to new systems and tools.

Preferred Qualifications

While not required, the following qualifications are highly desirable:

• Experience in a healthcare or insurance environment.
• Knowledge of medical terminology and healthcare concepts.
• Previous experience working in a remote or flexible work environment.

What We Offer

At blithequark, we're committed to supporting the well-being and success of our employees. Our comprehensive benefits package includes:

• Competitive hourly rate: $30-$41 per hour.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan and Employee Stock Purchase Plan.
• Term life insurance and short-term and long-term disability benefits.
• Wellness programs, education assistance, and free improvement courses.
• CVS store discount and rebate programs with participating partners.
• Paid Time Off (PTO) and holiday pay.

Career Growth and Development

At blithequark, we're committed 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 through ongoing training and development programs.
• Take on new challenges and responsibilities as you grow in your role.
• Explore opportunities for advancement within the organization.

Our Culture

At blithequark, we're passionate about creating a culture that is supportive, inclusive, and empowering. Our Heart At Work Behaviors guide our interactions with each other and with our members, and we're committed to fostering a work environment that is collaborative, innovative, and fun.

Why Join blithequark?

If you're passionate about delivering exceptional customer service and making a difference in the lives of others, we want to hear from you. Join our team at blithequark and be part of a dynamic organization that is shaping the future of healthcare.

Preparing for Your Interview

To help you prepare for your interview, we've put together some common questions and tips:

• Be ready to talk about your experience and skills, and how they align with the requirements of the role.
• Show enthusiasm and passion for delivering exceptional customer service.
• Be prepared to provide specific examples of times when you've gone above and beyond for a customer or colleague.
• Come prepared with questions to ask us about the role and the organization.

We look forward to hearing from you and discussing this opportunity further!