Experienced Customer Service Representative - Remote Medicare Appeals Support

Remote Full-time
Join the Team at blithequark: Empowering Better Health Outcomes blithequark is a pioneering health solutions company dedicated to delivering maximum value and impact through technology, services, and clinical expertise. Our mission is to innovate health solutions that improve people's lives, and we're looking for passionate individuals to join our team. As a Customer Service Representative, you will play a vital role in supporting the Medicare Appeal process, providing exceptional service to our customers, and contributing to our mission. About blithequark At blithequark, we're committed to redefining expectations for the healthcare industry. We bring together experienced leaders, clinicians, technologists, and industry professionals to ensure better healthcare and improve health outcomes. Our company culture is built on a foundation of care, innovation, and teamwork. We offer a dynamic and supportive work environment that encourages growth, learning, and collaboration. Job Summary We're seeking a highly skilled Customer Service Representative to join our growing team. As a remote employee, you will be responsible for supporting the Medicare Appeal process by answering incoming telephone calls, resolving customer questions, complaints, and requests, and adhering to internal policies and procedures. If you have a passion for delivering exceptional customer service and a strong understanding of the healthcare industry, we want to hear from you! Key Responsibilities Develop and maintain working knowledge of internal policies, procedures, and services (both departmental and operational) Utilize automated systems to log and retrieve information, and perform accurate and timely data entry of electronic faxes Receive inquiries from customers or providers by telephone, email, fax, or mail, and communicate responses within required turnaround times Respond to telephone inquiries and complaints in a prompt, accurate, and courteous manner, following standard operating procedures Interact with hospitals, physicians, beneficiaries, or other program recipients Investigate and resolve or report customer problems, identifying and escalating difficult situations to the appropriate party Meet or exceed standards for call volume and service level per department guidelines Initiate files by collecting and entering demographic, provider, and procedure information into the system Serve as a liaison between Review Supervisors and external providers Maintain logs and documents disposition of incoming and outgoing calls Requirements To be successful in this role, you will need: High School diploma or equivalent 2+ years of customer service/telephone experience in a similar call center environment and/or industry Ability to effectively communicate with team members and external customers Ability to research and resolve issues related to Medicaid program and service eligibility Bilingual (Spanish/English) Preferred Qualifications/Experience We prefer candidates with: Previous experience in a medical office or other medical setting General knowledge of eligibility verification (Medicaid eligibility and program requirements for specific program of focus) Knowledge of CPT and HCPCS codes PC proficiency, including Microsoft Office Suite Experience with Microsoft programs Career Growth Opportunities and Learning Benefits At blithequark, we're committed to helping our employees grow and develop their skills. We offer: Comprehensive training programs to help you succeed in your role Ongoing coaching and feedback to support your growth and development Opportunities for career advancement and professional growth Access to industry-leading tools and technologies Work Environment and Company Culture At blithequark, we pride ourselves on our dynamic and supportive work environment. We offer: A remote work arrangement that provides flexibility and work-life balance A collaborative and inclusive company culture that values diversity and teamwork Opportunities for socialization and connection with colleagues A commitment to employee well-being and mental health Compensation, Perks, and Benefits We offer a comprehensive compensation package that includes: A competitive salary range of $15.85 - $18.20 Comprehensive health plans Paid time off Retirement savings Corporate wellness programs Educational assistance Corporate discounts And more! Why Join blithequark? At blithequark, we're passionate about making a difference in people's lives. By joining our team, you'll have the opportunity to: Make a meaningful impact on the healthcare industry Work with a talented and dedicated team Develop your skills and advance your career Enjoy a dynamic and supportive work environment Receive a comprehensive compensation package How to Apply If you're passionate about delivering exceptional customer service and making a difference in the healthcare industry, we want to hear from you! Please submit your application, including your resume and cover letter, to [insert contact information]. We can't wait to welcome you to our team! blithequark is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law. 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