**Experienced Customer Service Representative – Work from Home (EST/PST) – Transforming Healthcare with Compassion and Empathy**

At blithequark, we're dedicated to delivering exceptional healthcare experiences that put our members at the heart of everything we do. As a Customer Service Representative, you'll play a vital role in shaping the future of healthcare by providing personalized support to our members, addressing their unique needs, and championing their best health. If you're passionate about making a difference in people's lives and thrive in a dynamic, fast-paced environment, we invite you to join our team and embark on a rewarding career journey. **About blithequark** blithequark is a leading healthcare organization committed to revolutionizing the way healthcare is delivered. Our purpose is to bring our heart to every moment of our members' health, ensuring that every interaction is guided by empathy, compassion, and a deep understanding of their needs. We're driven by a shared vision to make healthcare more personal, convenient, and affordable for all. **Our Heart At Work Behaviors** At blithequark, we believe that our Heart At Work Behaviors are the foundation of our success. These behaviors empower our team members to take ownership of their work, drive innovation, and deliver exceptional results. As a Customer Service Representative, you'll embody these behaviors by: * Demonstrating a customer-centric approach to every interaction * Embracing a growth mindset and seeking opportunities for continuous learning * Fostering a culture of empathy, compassion, and inclusivity * Collaborating with colleagues to achieve shared goals and objectives * Embodying a sense of accountability and ownership for your work **Job Summary** We're seeking an experienced Customer Service Representative to join our team on a permanent work-from-home basis. As a key member of our customer service team, you'll be responsible for providing exceptional support to our members, addressing their inquiries, and resolving complex issues in a timely and professional manner. If you're passionate about delivering outstanding customer experiences and have a proven track record of success in a customer-facing role, we encourage you to apply. **Key Responsibilities** * Respond to customer inquiries and resolve issues via phone, email, or written correspondence * Engage with members to understand their unique needs, preferences, and understanding of our plans, tools, and resources * Provide education and guidance to members on our plans, policies, and procedures * Anticipate customer needs and proactively offer solutions to address their concerns * Use our customer service threshold framework to make financial decisions to resolve member issues * Explain member rights and responsibilities in accordance with our contract * Process claim referrals, new claim handoffs, nurse reviews, complaints, grievances, and appeals * Educate providers on our self-service options and assist with credentialing and re-credentialing issues * Respond to requests from our Law Document Center regarding litigation and lawsuits * Handle extensive file review requests and assist in preparation of complaint trend reports * Determine medical necessity, applicable coverage provisions, and verify member plan eligibility * Perform review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible * Perform financial data maintenance as necessary **Essential Qualifications** * 1+ year of customer service experience in a transaction-based environment, such as a call center or retail location * Proven ability to be empathetic and compassionate in a customer-facing role * Experience in a production environment, with a focus on meeting productivity and quality standards * High school education or GED equivalent * Strong communication and interpersonal skills, with the ability to build rapport with members and colleagues * Ability to work in a fast-paced environment, with multiple priorities and deadlines * Proficiency in using technology, including CRM systems and Microsoft Office **Preferred Qualifications** * Experience in a healthcare or insurance environment * Knowledge of regulatory guidelines and compliance requirements * Certification in customer service or a related field * Bilingual or multilingual skills **Skills and Competencies** * Strong customer service skills, with a focus on empathy, compassion, and understanding * Excellent communication and interpersonal skills, with the ability to build rapport with members and colleagues * Ability to work in a fast-paced environment, with multiple priorities and deadlines * Strong problem-solving and critical thinking skills, with the ability to analyze complex issues and develop effective solutions * Proficiency in using technology, including CRM systems and Microsoft Office * Ability to work independently and as part of a team, with a focus on collaboration and teamwork **Career Growth Opportunities and Learning Benefits** At blithequark, we're committed to helping our team members grow and develop their careers. As a Customer Service Representative, you'll have access to a range of learning and development opportunities, including: * On-the-job training and coaching * Ongoing education and training programs * Mentorship and career development opportunities * Access to our internal career development platform, with a range of courses and resources * Opportunities for advancement and career growth within the organization **Work Environment and Company Culture** As a work-from-home Customer Service Representative, you'll have the flexibility to work from the comfort of your own home, with a range of benefits and perks to support your well-being and productivity. Our company culture is built on a foundation of empathy, compassion, and inclusivity, with a focus on collaboration, teamwork, and continuous learning. We're committed to creating a work environment that's supportive, engaging, and rewarding for all our team members. **Compensation, Perks, and Benefits** As a Customer Service Representative at blithequark, you'll enjoy a competitive compensation package, with a range of benefits and perks to support your well-being and productivity. Our benefits include: * Competitive hourly rate, with opportunities for advancement and career growth * Comprehensive medical, dental, and vision benefits * 401(k) retirement savings plan and Employee Stock Purchase Plan * Fully-paid term life insurance plan and short-term and long-term disability benefits * Paid Time Off (PTO) and paid holidays throughout the calendar year * Access to our internal career development platform, with a range of courses and resources * Opportunities for advancement and career growth within the organization **How to Apply** If you're passionate about delivering exceptional customer experiences and have a proven track record of success in a customer-facing role, we encourage you to apply. Please submit your application, including your resume and a cover letter, to [insert contact information]. We look forward to hearing from you! **Equal Employment Opportunity** blithequark is an equal employment opportunity employer, committed to diversity and inclusion in the workplace. We welcome applications from qualified candidates of all backgrounds, experiences, and perspectives. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state, and local laws. **Application Deadline** We anticipate the application window for this opening will close on: 09/09/2024. Don't miss this opportunity to join our team and embark on a rewarding career journey! Apply for this job