**Experienced Customer Service Representative (MA) - Remote Opportunity at blithequark**

Are you a customer service professional with a passion for delivering exceptional experiences to individuals in need of healthcare services? Do you thrive in a dynamic, fast-paced environment where no two calls are ever the same? If so, we invite you to join blithequark, a leading organization dedicated to helping people live healthier and more satisfying lives. **About blithequark** blithequark is a forward-thinking organization that values the talents and abilities of all its employees. Our mission is to foster an open, cooperative, and dynamic environment where employees and our health plans can thrive. As a member of our team, you will be part of a dynamic organization that considers all employees as leaders in driving the organization forward and delivering quality service to our members. **Our Health Plans** blithequark operates two health plans: McLaren Health Plan, our Michigan-based health plan dedicated to meeting the healthcare needs of our Michigan members, and MDwise, Inc., our Indiana-based health plan working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy Indiana Plan health insurance programs. Learn more about our health plans at [ and [ **Job Summary** We are seeking an experienced Customer Service Representative (MA) to join our team in a fully remote capacity. As a Customer Service Representative, you will be responsible for daily member telephone calls, directing members to the proper services needed, educating members, problem-solving, and creating linkages to the Medical Management Department for authorization of services. You may also be responsible for assisting providers with eligibility, benefit, and resolution of claims issues. **Key Responsibilities:** * Respond to daily member telephone calls in a professional and courteous manner * Direct members to the proper services needed, including educating them on available resources and benefits * Problem-solve and resolve member issues in a timely and efficient manner * Create linkages to the Medical Management Department for authorization of services * Assist providers with eligibility, benefit, and resolution of claims issues * Maintain accurate records and documentation of member interactions * Collaborate with internal teams to ensure seamless service delivery **Essential Qualifications:** * High School Diploma or equivalent certification * One (1) year experience in a customer service related role with direct contact with customers via telephone, email, chat, and/or face-to-face * Strong communication and interpersonal skills * Ability to work in a fast-paced environment with multiple priorities and deadlines * Basic computer skills and proficiency in Microsoft Office **Preferred Qualifications:** * One (1) year experience in a physician healthcare office environment or high-volume call center * One (1) year experience and knowledge of HMO, PPO, TPA, PHO, and Managed Care functions * Experience working with Medicare population * Certification in customer service or a related field **Skills and Competencies:** * Excellent communication and interpersonal skills * Strong problem-solving and analytical skills * Ability to work independently and as part of a team * Basic computer skills and proficiency in Microsoft Office * Strong attention to detail and organizational skills * Ability to maintain confidentiality and handle sensitive information **Career Growth Opportunities and Learning Benefits:** * Opportunities for professional growth and development in a dynamic and fast-paced environment * Access to training and development programs to enhance your skills and knowledge * Collaborative and supportive work environment with a team of dedicated professionals * Flexible work arrangements, including remote work options **Work Environment and Company Culture:** * blithequark is an equal opportunity employer committed to diversity and inclusion * We offer a dynamic and supportive work environment with a team of dedicated professionals * Our company culture values collaboration, innovation, and customer satisfaction * We are committed to providing a safe and healthy work environment for all employees **Compensation, Perks, and Benefits:** * Competitive salary and benefits package * Comprehensive health insurance plan * 401(k) retirement plan with company match * Paid time off and holidays * Flexible work arrangements, including remote work options * Opportunities for professional growth and development **How to Apply:** If you are a motivated and customer-focused individual with a passion for delivering exceptional service, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and cover letter, through our website at [ We look forward to hearing from you! Apply for this job