Transforming Healthcare with Exceptional Customer Service
At blithequark, we're on a mission to revolutionize the healthcare industry by putting our heart into every moment of your health. Our purpose is clear: to deliver enhanced human-centric health care that's more personal, convenient, and affordable. As a Customer Service Representative on our Claims Inquiry and Research Team, you'll play a vital role in achieving this goal by providing top-notch service to our members, providers, and plan sponsors.
About blithequark and the Industry
blithequark is a leader in the healthcare industry, committed to making a positive impact on people's lives. We're part of a rapidly evolving landscape where customer expectations are changing, and technology is advancing at an unprecedented rate. As a result, we're dedicated to innovating and delivering solutions that meet the needs of our customers. Our Heart At Work Behaviors guide our actions, ensuring that we're not just delivering services but doing so with empathy, care, and a deep understanding of our customers' needs.
Key Responsibilities
- Respond to phone calls and letters from members, providers, and plan sponsors, resolving issues and answering questions in a timely and professional manner.
- Provide exceptional customer service, particularly for high-volume inbound provider calls, ensuring that their queries are addressed efficiently and effectively.
- Conduct extensive claims research across multiple platforms to assist providers with payment questions, demonstrating a thorough understanding of our systems and processes.
- Offer related information to customers to proactively address their unasked questions, such as additional plan details, benefit plan information, and member self-service tools.
- Utilize our customer service threshold framework to make informed financial decisions that resolve member issues, ensuring that we're balancing customer needs with business requirements.
- Process claim referrals, new claim handoffs, nurse reviews, complaints, grievances, and appeals via our target system, maintaining accuracy and efficiency.
- Educate and assist providers on our self-service options, promoting adoption and reducing the need for direct support.
- Assist providers with credentialing, re-credentialing, and contracting questions and issues, serving as a trusted resource and point of contact.
- Compile claim data for customer audits, demonstrating attention to detail and organizational skills.
- Determine medical necessity, applicable coverage provisions, and verify member plan eligibility relating to incoming correspondence and internal referrals, showcasing critical thinking and analytical abilities.
Essential Qualifications
- Familiarity with Microsoft Office products, including Word, Teams, and Excel, to effectively manage and analyze data.
- The ability to navigate multiple applications simultaneously while on a call, ensuring that you're providing accurate and timely information.
- Experience in a highly transactional call center environment, where you've developed strong customer service skills and the ability to handle a high volume of calls.
- Excellent customer service and critical thinking skills, with the ability to empathize with customers, understand their needs, and provide effective solutions.
- A secure and stable high-speed internet connection (100 Mbps or higher) and a direct connection to the router (not Wi-Fi) to ensure seamless remote work.
Preferred Qualifications
- A background in healthcare, which can provide a deeper understanding of our industry and the needs of our customers.
Education and Compensation
A High School diploma or GED equivalent is required for this role. The typical pay range for this position is $17.00 - $28.46 per hour, depending on factors such as experience, education, and geography.
What We Offer
At blithequark, we're committed to caring for our colleagues and communities. Our comprehensive benefits package includes:
- A full range of medical, dental, and vision benefits.
- A 401(k) retirement savings plan and an Employee Stock Purchase Plan.
- A fully-paid term life insurance plan and short-term and long-term disability benefits.
- Numerous well-being programs, education assistance, and free development courses to support your growth and well-being.
- A CVS store discount and discount programs with participating partners.
- Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year.
Career Growth and Development
As a Customer Service Representative at blithequark, you'll have opportunities to grow and develop your skills in a dynamic and supportive environment. You'll be part of a team that's passionate about delivering exceptional customer service and making a positive impact on the healthcare industry. Our culture encourages learning, innovation, and collaboration, ensuring that you're equipped to succeed in your role and advance in your career.
Work Environment and Culture
We're a remote-friendly organization that values flexibility and work-life balance. As a fully remote role, you'll have the opportunity to work from home, setting up your workspace to suit your needs. We're committed to creating an inclusive and diverse culture that welcomes individuals from all backgrounds and perspectives.
Why Join blithequark?
If you're passionate about delivering exceptional customer service, working in a dynamic and supportive environment, and making a positive impact on the healthcare industry, we want to hear from you. At blithequark, we're dedicated to putting our heart into every moment of your health, and we're looking for talented individuals to join our team. Apply now to become a part of our mission to transform healthcare.
blithequark is an equal opportunity and affirmative action employer, committed to diversity and inclusion. We don't discriminate based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by law.
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