Experienced Customer Service Representative – Remote Full-Time Opportunity with blithequark at $30/Hour

Introduction to blithequark At blithequark, we share a singular, clear purpose: to bring our heart to every moment of our customers' well-being. This purpose guides our commitment to deliver enhanced, human-driven healthcare for a rapidly changing world. Embedded in our brand — with heart at its center — our mission sends a personal message that how we deliver our services is just as important as what we deliver. We are dedicated to making healthcare more personalized, convenient, and affordable. Our Heart At Work Behaviors Our Heart At Work Behaviors support this purpose. We want every individual who works at blithequark to feel empowered by the role they play in transforming our culture and accelerating our ability to grow and deliver solutions to make healthcare more accessible. We strive to create an environment where our employees can thrive, grow, and make a meaningful difference in the lives of our customers. Job Overview We are seeking an experienced Customer Service Representative to join our team at blithequark. As the face of our company, you will influence our customers' service experience by handling customer care requests and issues via phone, web, or written correspondence. Your ability to engage, consult, and educate our customers based on their unique needs, preferences, and understanding of our plans, tools, and resources will be essential in guiding them along a path to better health. Key Responsibilities Respond to questions and resolve issues based on calls/letters from customers, providers, and plan sponsors. Escalate emergencies to the appropriate staff and record and track contacts with customers, providers, and plan sponsors. Guide customers through their plan of benefits, blithequark policy, and procedures, as well as being aware of resources to comply with any regulatory requirements. Make a personal connection with our customers by understanding and engaging them to the fullest to support their best health. Take ownership to understand the customer's needs by building a trusting and caring relationship with them. Anticipate customer needs and provide them with relevant information to address unasked questions, such as additional plan details, benefit plan details, customer self-service tools, and more. Utilize customer support limit framework to make financial decisions to resolve customer issues. Explain customer limitations as per contract. Process claim referrals, new case handoffs, nurse reviews, complaints (customer/provider), and appeals (customer/provider) via our target system. Educate providers on our self-service options and assist them with credentialing and re-credentialing issues. Answer demands received from blithequark's Regulation Record Place regarding litigation and claims, and handle broad document review demands. Aid in the preparation of complaint pattern reports and assist with incorporating claim data for customer reviews. Determine clinical needs, relevant coverage policies, and check customer plan eligibility related to incoming communication and internal referrals. Handle incoming requests for authorizations and pre-approvals not handled by Clinical Case Management. Perform a review of customer claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible. Perform financial data entry as needed. Utilize relevant system tools and resources to create quality letters and spreadsheets in response to requests received. Essential Qualifications Bachelor's degree required. Customer service experience in a transaction-based environment, such as a call center or retail store, is preferred, demonstrating the ability to be empathetic and compassionate. Experience in a production environment. Ability to multitask to efficiently accomplish tasks. Understanding of medical terminology. Effective oral and written communication skills. Proficient in Microsoft Word and Outlook. Ability to maintain accuracy and production standards. Strong communication and interpersonal skills. Technical skills. Problem-solving abilities. Attention to detail and accuracy. Preferred Qualifications Prior experience in a customer-facing role, preferably in the healthcare industry. Knowledge of healthcare plans, policies, and procedures. Experience with customer relationship management (CRM) software. Strong analytical and problem-solving skills. Ability to work in a fast-paced environment and adapt to changing priorities. Career Growth Opportunities and Learning Benefits At blithequark, we are committed to the growth and development of our employees. We offer a range of training programs, workshops, and online courses to help you enhance your skills and knowledge. Our goal is to provide you with the tools and resources you need to succeed in your role and advance your career. With opportunities for advancement and professional growth, you can build a long-term career with blithequark. Work Environment and Company Culture Our company culture is built on the values of empathy, compassion, and respect. We believe in creating a work environment that is inclusive, supportive, and empowering. Our employees are our greatest asset, and we strive to provide a positive and productive work environment that allows them to thrive. With a strong focus on work-life balance, we offer flexible scheduling, remote work options, and a range of employee benefits to support your overall well-being. Compensation, Perks, and Benefits We offer a competitive salary range of $30-$41 per hour, depending on experience. In addition to your compensation, you will enjoy a range of benefits, including medical, dental, and vision insurance, a 401(k) retirement savings plan, and a Employee Stock Purchase Plan. We also offer a range of wellness programs, education assistance, and free development courses to support your personal and professional growth. Conclusion If you are a motivated and customer-focused individual who is passionate about delivering exceptional service, we encourage you to apply for this exciting opportunity with blithequark. As a Customer Service Representative, you will play a critical role in shaping our customers' experience and driving our mission to make healthcare more personalized, convenient, and affordable. Join our team and be part of a dynamic and growing organization that is dedicated to making a difference in the lives of our customers. Apply for this job