Introduction to blithequark
At blithequark, we share a singular, clear purpose: Carrying our heart to each snapshot of your wellbeing. This purpose directs our obligation to deliver enhanced human-driven healthcare for a quickly impacting world. Secured in our brand — with heart at its middle — our motivation sends an individual message that how we convey our administrations is similarly essentially as significant as what we convey. We are committed to making healthcare more private, convenient, and affordable.
Job Overview
We are seeking an experienced Customer Service Representative to join our team at blithequark. As the face of blithequark, you will influence individuals' service experience by handling customer care requests and issues via phone, web, or written correspondence. Your role will be to engage, consult, and educate individuals based on their unique needs, preferences, and understanding of blithequark plans, tools, and assets to guide them along a path to care.
Key Responsibilities
- Respond to questions and resolve issues resulting from calls/letters from individuals, suppliers, and plan sponsors.
- Emergency situations are escalated to the appropriate staff, and records and tracks contacts with individuals, suppliers, and plan sponsors.
- Guide the member through their individual plan of benefits, blithequark policy, and procedures, as well as being aware of resources to comply with any regulatory requirements.
- Make a personal connection with our members by understanding and engaging the member to the fullest to support our members' best health.
- Take ownership to understand the member's needs by building a trusting and caring relationship with the member completely.
- Anticipate customer needs and provide the customer with relevant information to address the unasked questions, such as extra plan details, benefit plan details, member self-service tools, etc.
- Utilize customer support limit system to make financial decisions to resolve member issues.
- Explain member's limitations as per contract.
- Process claim referrals, new case handoffs, nurse reviews, complaints (member/supplier), and appeals (member/supplier) via target system.
- Educate suppliers on our self-service options and help suppliers with credentialing and re-credentialing issues.
- Answer demands received from blithequark's Regulation Record Place regarding litigation and claims, and handle broad document review demands.
- Aid in the preparation of complaint pattern reports and assist with incorporating claim data for customer reviews.
- Determine clinical needs, relevant coverage policies, and check member plan eligibility related to incoming communication and internal referrals.
- Handle incoming requests for authorizations and pre-approvals not handled by Clinical Case Management.
- Perform a review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible.
- Perform financial data entry as needed.
- Utilize relevant system tools and resources to create quality letters and spreadsheets in response to requests received.
Essential Qualifications
To be successful in this role, you will need:
- A Bachelor's Degree.
- Customer service experience in a transaction-based environment, such as a call center or retail store, is preferred, demonstrating the ability to be empathetic and compassionate.
- Experience in a production environment.
- Ability to multitask to efficiently accomplish tasks.
- Understanding of medical terminology.
- Effective oral and written communication skills.
- Proficient with Microsoft Word and Outlook.
- Ability to maintain accuracy and production standards.
- Interpersonal skills.
- Technical skills.
- Problem-solving skills.
- Attention to detail and accuracy.
Preferred Qualifications
While not required, the following qualifications are preferred:
- Prior experience in a customer-facing role, particularly in healthcare or insurance.
- Knowledge of healthcare policies and procedures.
- Experience with customer relationship management (CRM) software.
Career Growth Opportunities and Learning Benefits
At blithequark, we are committed to the growth and development of our employees. As a Customer Service Representative, you will have access to:
- Comprehensive training programs to enhance your skills and knowledge.
- Opportunities for career advancement and professional growth.
- A supportive and collaborative work environment that encourages learning and development.
- Access to a wide range of resources and tools to help you succeed in your role.
Work Environment and Company Culture
At blithequark, we pride ourselves on our positive and inclusive company culture. As an employee, you can expect:
- A dynamic and supportive work environment that encourages collaboration and teamwork.
- A culture that values diversity, equity, and inclusion.
- Opportunities to participate in company-wide initiatives and events.
- A comprehensive benefits package that includes medical, dental, and vision coverage, as well as a 401(k) retirement savings plan and employee stock purchase plan.
Compensation, Perks, and Benefits
We offer a competitive compensation package that includes:
- A hourly rate of $30-$41 per hour.
- A comprehensive benefits package that includes medical, dental, and vision coverage.
- A 401(k) retirement savings plan and employee stock purchase plan.
- Paid time off (PTO) and holidays.
- Access to a wide range of discounts and perks, including discounts on blithequark products and services.
Conclusion
If you are a motivated and customer-focused individual who is passionate about delivering exceptional service, we encourage you to apply for this exciting opportunity to join our team at blithequark. As a Customer Service Representative, you will play a critical role in ensuring that our members receive the highest level of service and support. Don't miss out on this chance to join a dynamic and growing company that is dedicated to making a positive impact in the lives of our members.
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