**Experienced Customer Service Representative - National Remote**

Are you a compassionate and customer-focused individual looking to make a meaningful impact in the healthcare industry? Do you thrive in a fast-paced, dynamic environment where no two days are ever the same? If so, we invite you to join blithequark, a leading healthcare solutions provider, as a Customer Service Representative in our National Remote team. At blithequark, we're committed to creating a healthier world by delivering innovative healthcare solutions that improve the lives of millions of people. As a Customer Service Representative, you'll play a critical role in creating a quality experience for our members and their families, exceeding their expectations, and making a profound and personal impact in the healthcare industry. **About blithequark** blithequark is a leading healthcare solutions provider, dedicated to creating a healthier world by delivering innovative healthcare solutions that improve the lives of millions of people. With a strong commitment to excellence, we strive to create a work environment that is inclusive, supportive, and empowering. Our mission is to help people live healthier lives and make the health system work better for everyone. **About the Role** As a Customer Service Representative, you'll be responsible for providing exceptional customer service to our members and their families, responding to their inquiries, resolving issues, and exceeding their expectations. You'll work in a fast-paced, dynamic environment, where no two days are ever the same. You'll be empowered to make decisions, take ownership of problems, and provide solutions that meet the needs of our members. **Key Responsibilities** * Answer incoming phone calls from customers and identify the type of assistance they need (i.e., benefit and eligibility, billing and payments, authorizations for treatment, and explanation of benefits / EOBs) * Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems * Own problems through to resolution on behalf of the customer in real-time or through comprehensive and timely follow-up with the member * Review and research incoming healthcare claims from members and providers by navigating multiple computer systems and platforms and verifies the data / information necessary for processing (e.g., pricing, prior authorizations, applicable benefits) * Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g., claims processing policies and procedures, grievance procedures, state mandates, CMS / Medicare guidelines, benefit plan, documents / certificates) * Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding * Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction, and attendance **Essential Qualifications** * High School Diploma / GED OR equivalent experience * 1 year of prior experience in a call center setting * 1 year of experience in a customer service role * Experience with working in the healthcare and health insurance industry * Experience with Medical Terminology * Experience with working in a metric-driven work environment * Ability to work any 8-hour shift between the hours of 8:00 AM - 4:30 PM CST from Monday - Friday (they need to work this shift no matter what time zone they are on), including the flexibility to work occasional overtime based on business need * Must be 18 years of age OR older **Telecommuting Requirements** * Ability to keep all company sensitive documents secure (if applicable) * Required to have a dedicated work area established that is separated from other living areas and provides information privacy * Must live in a location that can receive a blithequark approved high-speed internet connection or leverage an existing high-speed internet service **Soft Skills** * Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manner, consistently meeting commitments) * Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests, and identify the current and future needs of the member * Proficient problem-solving approach to quickly assess current state and formulate recommendations * Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon * Flexibility to customize approach to meet all types of member communication styles and personalities * Proficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrating personal resilience * Ability to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and / or weekends, as needed **Compensation and Benefits** We offer a comprehensive benefits package, including: * Competitive hourly rate ($16.00 - $28.27 per hour) * Comprehensive benefits package * Incentive and recognition programs * Equity stock purchase * 401k contribution * Paid on-the-job training * Opportunities for career growth and advancement **Work Environment and Culture** At blithequark, we're committed to creating a work environment that is inclusive, supportive, and empowering. We believe in the importance of diversity, equity, and inclusion, and we strive to create a workplace that reflects the diversity of our members and the communities we serve. We're committed to providing a work environment that is safe, healthy, and respectful, and we encourage our employees to bring their whole selves to work. **How to Apply** If you're a motivated and customer-focused individual looking to make a meaningful impact in the healthcare industry, we invite you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, through our website. We look forward to hearing from you! **Equal Employment Opportunity** blithequark is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. **Drug-Free Workplace** blithequark is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. **Application Deadline** This job posting will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. Apply for this job