Experienced Medical Claims Customer Service Representative – Remote Healthcare Professional for Exceptional Patient Care and Operational Excellence at blithequark

Welcome to blithequark: Empowering Healthcare Excellence At blithequark, we are a pioneering, data-driven healthcare organization dedicated to operational excellence and committed to making high-quality healthcare affordable for all. Our mission is built on the principles of enhancing patient health, renewing the satisfaction of practicing medicine for healthcare providers, and fostering stronger connections between patients and providers through the integration of empathy, AI, and predictive analytics. As a physician-led team, we empower our partners to deliver exceptional healthcare, prioritizing outcomes and value for all patients. We believe in a future where healthcare is not just about treating illnesses but about promoting wellness and improving the quality of life for individuals and communities. Your Role as a Medical Claims Customer Service Representative As a key player in our team, you will be responsible for ensuring timely and effective responses to client and member calls, solving problems, working collaboratively, and meeting quality standards. Your role involves providing courteous and professional service while handling various tasks and projects, including mailing assistance. You will be the voice of blithequark, representing our commitment to exceptional patient care and operational excellence. Your dedication to delivering outstanding customer service will be crucial in addressing inquiries related to claims payment, status, and coverage information, interpreting client health plan protocols, and assisting with claims processing tasks. Key Responsibilities: Handle client and member calls with accuracy and follow-through, ensuring that all inquiries are addressed promptly and professionally. Deliver outstanding customer service, maintaining a high level of professionalism and courtesy in all interactions. Address inquiries related to claims payment, status, and coverage information, providing clear and concise explanations to clients and members. Interpret client health plan protocols, ensuring that all services are delivered in accordance with the agreed-upon terms and conditions. Assist with claims processing tasks, including reports and workflow queues, to ensure that all claims are processed efficiently and effectively. Document calls accurately and maintain high professionalism, ensuring that all records are up-to-date and compliant with regulatory requirements. Return incoming calls and perform additional duties as assigned, demonstrating flexibility and a willingness to support the team as needed. Essential Qualifications: To be successful in this role, you will need: 1 to 3 years of customer service experience in healthcare, with a proven track record of delivering exceptional customer service in a fast-paced environment. Knowledge of healthcare claims processing, including an understanding of claims payment, status, and coverage information. Experience in a high-volume call center, with the ability to handle multiple calls simultaneously while maintaining a high level of professionalism and courtesy. Background in healthcare or health insurance, with a strong understanding of the healthcare industry and its complexities. Familiarity with BCBS HMOI or other insurance plans, with the ability to interpret client health plan protocols and provide clear explanations to clients and members. Proficiency in Microsoft Office and multiple systems, with the ability to learn new software applications quickly and efficiently. Excellent verbal and written communication skills, with the ability to communicate complex information in a clear and concise manner. Availability for an 8-hour shift between 8 AM and 6 PM Central Time, with flexibility to work varying shifts as needed. Preferred Qualifications: While not required, the following qualifications are preferred: Experience with HMO Managed Care and Medicare Advantage, with a strong understanding of the complexities of managed care and Medicare Advantage plans. Previous experience working in a remote or virtual environment, with the ability to work independently and as part of a team. Certifications or training in customer service, healthcare, or a related field, with a commitment to ongoing learning and professional development. Skills and Competencies: To succeed in this role, you will need to possess the following skills and competencies: Communication skills: Excellent verbal and written communication skills, with the ability to communicate complex information in a clear and concise manner. Problem-solving skills: Strong problem-solving skills, with the ability to analyze complex issues and develop effective solutions. Collaboration and teamwork: Ability to work collaboratively as part of a team, with a strong commitment to supporting colleagues and achieving shared goals. Adaptability and flexibility: Ability to adapt to changing circumstances and priorities, with a willingness to learn new skills and take on new challenges. Attention to detail: Strong attention to detail, with the ability to accurately document calls and maintain high professionalism. Career Growth Opportunities and Learning Benefits: At blithequark, we are committed to supporting the career growth and development of our employees. As a Medical Claims Customer Service Representative, you will have access to a range of training and development opportunities, including: Professional development programs: Ongoing training and development programs to enhance your skills and knowledge in customer service, healthcare, and related fields. Career advancement opportunities: Opportunities for career advancement within the company, with a range of roles and positions available to support your long-term career goals. Mentorship and coaching: Mentorship and coaching from experienced professionals, with a strong commitment to supporting your growth and development as a healthcare professional. Work Environment and Company Culture: At blithequark, we pride ourselves on our positive and supportive work environment, with a strong commitment to diversity, inclusion, and belonging. As a Medical Claims Customer Service Representative, you will be part of a dynamic and collaborative team, with a range of benefits and perks to support your well-being and job satisfaction, including: Remote work options: The flexibility to work from home, with the ability to balance your work and personal life. Comprehensive benefits package: A comprehensive benefits package, including health coverage, retirement planning, and paid time off. Professional growth opportunities: Opportunities for professional growth and development, with a range of training and development programs available. Supportive team environment: A supportive team environment, with a strong commitment to collaboration, teamwork, and mutual respect. Compensation, Perks, and Benefits: As a Medical Claims Customer Service Representative at blithequark, you will be eligible for a range of compensation, perks, and benefits, including: Competitive salary: A competitive salary, with a base pay range of $18.45 to $20.50 per hour, paid bi-weekly. Comprehensive benefits package: A comprehensive benefits package, including health coverage, retirement planning, and paid time off. Flexible work arrangements: Flexible work arrangements, including the ability to work from home and balance your work and personal life. Professional development opportunities: Opportunities for professional growth and development, with a range of training and development programs available. Conclusion: If you are a motivated and compassionate healthcare professional looking for a challenging and rewarding role, we encourage you to apply for the Medical Claims Customer Service Representative position at blithequark. As a key player in our team, you will have the opportunity to make a real difference in the lives of our clients and members, while also advancing your career and achieving your professional goals. With a strong commitment to diversity, inclusion, and belonging, we welcome applications from qualified candidates of all backgrounds and experiences. Apply today to join our dynamic and collaborative team and take the first step towards a rewarding and challenging career in healthcare. Apply for this job