Experienced Full Stack Customer Service Representative – Healthcare Industry at Blithequark

Join the Blithequark Team: Delivering Exceptional Healthcare Experiences At Blithequark, we're dedicated to transforming the healthcare industry by providing personalized, convenient, and affordable services. Our mission is to put our heart into every aspect of healthcare, making a positive impact on the lives of our members and the communities we serve. We're seeking a highly skilled and compassionate Customer Service Representative to join our team, working remotely from California, USA. About the Role As a Customer Service Representative at Blithequark, you'll be the face of our organization, influencing the service experience of our members through phone, web, or written correspondence. You'll handle complex customer inquiries, resolve issues, and provide guidance on our plans, tools, and resources. Your goal will be to build trust, empathy, and a deep understanding of our members' needs, ensuring they receive the best possible care. Key Responsibilities: Respond to questions and resolve issues from members, providers, and plan sponsors via phone, email, or written correspondence. Escalate emergencies to the appropriate staff and record/track contacts with members, providers, and plan sponsors. Guide members through their plan benefits, Blithequark policies, and procedures, while being aware of resources to comply with regulatory requirements. Build personal connections with members by understanding and engaging with them to support their best health outcomes. Take ownership of understanding members' needs by establishing trusting and caring relationships. Anticipate member needs and provide relevant information to address unasked questions. Utilize customer service tools and systems to make informed decisions and resolve member issues. Explain member limitations according to contract and process claims references, new case handoffs, and other related tasks. Educate providers on self-service options and assist with credentialing and re-credentialing issues. Handle document review requests, litigation claims, and audit demands. Contribute to the preparation of protest pattern reports and integrate claims data for client reviews. Determine clinical needs, relevant coverage policies, and check member plan eligibility. Perform reviews of member claims history to ensure accurate tracking of benefit maximums and coinsurance/deductible. Provide financial data support as needed. Utilize system tools and resources to generate quality letters and spreadsheets in response to requests. Requirements and Qualifications Essential Qualifications: Bachelor's degree in a related field. Experience in customer service, preferably in a call center or healthcare environment. Strong knowledge of clinical terminology. Excellent oral and written communication skills. Proficiency in Microsoft Word and Outlook. Ability to maintain accuracy and productivity standards. Strong problem-solving and critical thinking skills. Compassionate and empathetic approach to customer service. Preferred Qualifications: Previous experience in a healthcare setting. Familiarity with healthcare regulations and policies. Experience with customer relationship management (CRM) software. Certification in customer service or a related field. What We Offer At Blithequark, we're committed to creating a work environment that supports the well-being of our employees. Here are some of the benefits and perks we offer: Competitive hourly rate of $30-$41. Full-time position with 8 hours of work per day. Opportunities for career growth and professional development. Comprehensive benefits package, including medical, dental, and vision coverage. 401(k) retirement savings plan and employee stock purchase plan. Paid time off (PTO) and vacation pay. Paid holidays and sick leave. Access to employee assistance programs (EAPs) and wellness initiatives. Our Culture and Values At Blithequark, we value our employees and strive to create a work environment that's inclusive, supportive, and empowering. Here are some of the core values and behaviors that guide our organization: Putting our heart into every aspect of healthcare. Embracing a culture of empathy, compassion, and kindness. Fostering a spirit of collaboration and teamwork. Encouraging innovation and creativity. Supporting the growth and development of our employees. How to Apply If you're passionate about delivering exceptional customer experiences and making a positive impact in the healthcare industry, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, to join our team at Blithequark. Don't miss this chance to be part of a dynamic team that's shaping the future of healthcare. Apply now and start your journey with Blithequark! Apply for this job