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 bring our heart to every moment of your health. Our mission is to deliver enhanced, human-driven healthcare in a rapidly changing world. We're committed to making healthcare more personal, convenient, and affordable. As a Customer Service Representative at blithequark, you'll play a vital role in shaping the member experience and driving our mission forward.

About the Role

We're seeking an experienced Customer Service Representative to join our team on a full-time basis. As a Customer Service Representative, you'll be the face of blithequark, interacting with members, providers, and plan sponsors to resolve issues, answer questions, and provide personalized support. This is a remote opportunity, allowing you to work from anywhere in California, USA.

Key Responsibilities

• Respond to inquiries and resolve issues via phone, web, or written correspondence from members, providers, and plan sponsors.
• Engage with members to understand their unique needs, preferences, and understanding of blithequark plans, tools, and resources.
• Guide members through their plan benefits, blithequark policies, and procedures, ensuring compliance with regulatory guidelines.
• Build trusting relationships with members by providing empathetic and personalized support.
• Anticipate member needs and provide relevant information to address unasked questions.
• Utilize customer service skills to make informed decisions and resolve member issues.
• Process claims, new case handoffs, nurture reviews, complaints, and requests via our target system.
• Educate providers on our self-service options and assist with credentialing and re-credentialing issues.
• Respond to demands from blithequark's Regulation Record Place regarding litigation and claims.
• Assist with preparing protest pattern reports and integrating claim data for client reviews.
• Determine clinical needs, relevant coverage policies, and verify member plan 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:

• A Bachelor's degree from an accredited institution.
• Customer service experience in a transaction-based environment, such as a call center or retail store.
• Excellent communication and interpersonal skills.
• Ability to multitask and efficiently achieve responsibilities.
• Basic understanding of medical terminology.
• Proficient in Microsoft Word and Outlook.
• Strong problem-solving and analytical skills.
• Attention to detail and accuracy.

Preferred Qualifications

While not required, the following qualifications are highly preferred:

• Experience working in a production environment.
• Technical skills, including proficiency in CRM software.
• Previous experience in the healthcare industry.

What We Offer

At blithequark, we're committed to taking care of our employees and providing a comprehensive benefits package, including:

• Competitive hourly rate: $30-$41/hour.
• Medical, dental, and vision benefits.
• 401(k) retirement savings plan and Employee Stock Purchase Plan.
• Term life insurance, 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 holidays throughout the calendar year.

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 in customer service and healthcare.
• Take on new challenges and responsibilities.
• Participate in training and development programs.
• Advance to leadership roles or specialized positions.

Our Culture

At blithequark, we're passionate about our mission and committed to creating a positive and inclusive work environment. Our Heart At Work Behaviors guide our interactions with each other and with our members. We value:

• Empathy and compassion.
• Collaboration and teamwork.
• Innovation and continuous improvement.
• Diversity, equity, and inclusion.

Ready to Apply?

If you're a motivated and compassionate customer service professional looking to make 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 be considered for this role.

Don't miss this chance to join blithequark and be part of a team that's dedicated to making healthcare more personal, convenient, and affordable. Apply now and take the first step towards a rewarding career with blithequark!