Experienced Full Stack Customer Service Representative – National Remote Health Benefits and Claims Resolution

Join the Team at Blithequark: Where Compassion Meets Innovation in Healthcare Blithequark is revolutionizing the healthcare industry by providing top-notch health benefit plans to millions of people across the nation. As a leader in the third-party administrator (TPA) solutions, we're dedicated to creating higher quality care, lower costs, and greater access to healthcare. Our mission is to help people live healthier lives and make the health system work better for everyone. We're looking for a compassionate and skilled Customer Service Representative to join our team and make a profound impact on the lives of our members and their families. About the Role As a Customer Service Representative at Blithequark, you'll play a critical role in delivering exceptional customer service and resolving healthcare claims with empathy and expertise. You'll work in a fast-paced, dynamic environment, responding to calls from our members, answering questions, and resolving issues related to healthcare eligibility, claims, and payments. You'll also review and process healthcare claims, ensuring that every claim receives a fair and thorough review. Key Responsibilities: Respond to incoming phone calls from customers, identifying their needs and providing assistance with benefit and eligibility, billing and payments, authorizations for treatment, and explanation of benefits (EOBs) Ask relevant questions, listen actively, and document required information in computer systems Resolve customer issues in real-time or through comprehensive and timely follow-up Review and research incoming healthcare claims from members and providers, verifying data and information necessary for processing Ensure that proper benefits are applied to each claim, using appropriate processes and procedures Communicate and collaborate with members and providers to resolve issues, using clear and simple language Meet performance goals established for the position, including efficiency, accuracy, quality, member satisfaction, and attendance Requirements and Qualifications Essential Qualifications: High School Diploma or equivalent experience 1 year of prior experience in a call center setting 1 year of experience in a customer service role Experience working in the healthcare and health insurance industry Experience with Medical Terminology Experience working in a metric-driven work environment Ability to work any 8-hour shift between 8:00 AM - 4:30 PM CST, Monday - Friday, including flexibility to work occasional overtime Must be 18 years of age or older Preferred Qualifications: Previous experience with healthcare claims processing and benefits administration Familiarity with healthcare regulations and guidelines, such as CMS/Medicare Excellent problem-solving and analytical skills Strong communication and interpersonal skills What We Offer Compensation and Benefits: We offer a comprehensive benefits package, including: Competitive hourly rate ($16.00 - $28.27 per hour, depending on location and experience) Incentive and recognition programs Equity stock purchase 401k contribution Comprehensive benefits package Career Growth and Development: At Blithequark, we're committed to helping our employees grow and develop their careers. You'll have access to: Weeks of paid on-the-job training Ongoing coaching and feedback Career advancement opportunities Professional development programs Work Environment and Culture: We pride ourselves on a culture that values compassion, empathy, and innovation. As a remote employee, you'll enjoy: Flexibility to work from anywhere within the U.S. Autonomy to manage your work schedule Opportunities to connect with colleagues and leadership A dynamic and supportive work environment How to Apply If you're passionate about delivering exceptional customer service and making a difference in the lives of others, 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 team that's shaping the future of healthcare! Apply for this job