Experienced Customer Service Representative - Remote - Delivering Exceptional Member Experiences in Healthcare

Join the Team at blithequark: Where Exceptional Customer Service Meets Healthcare Excellence

blithequark is a leading organization dedicated to helping people live healthier and more satisfying lives. As a pioneer in the healthcare industry, we are committed to delivering top-notch services to our members. We are seeking a highly skilled and compassionate Customer Service Representative to join our dynamic team. As a Customer Service Representative, you will play a vital role in providing exceptional service to our members, resolving their concerns, and educating them about our health plans.

About blithequark

blithequark is a division of a larger healthcare organization with a culture of high performance and a mission to improve the lives of our members. Our subsidiaries, including blithequark Health Plan and blithequarkwise, Inc., value the talents and abilities of all our employees and strive to create an open, cooperative, and dynamic environment. As an employee of blithequark, you will be part of a team that considers all employees as leaders in driving the organization forward and delivering quality service to our members.

Our Health Plans

blithequark Health Plan is our Michigan-based health plan dedicated to meeting the healthcare needs of each of our Michigan members. Learn more about our health plan and the services we offer. blithequarkwise, Inc. is our Indiana-based health plan, working with the State of Indiana and Centers for Medicare and Medicaid Services to bring you the Hoosier Healthwise and Healthy Indiana Plan health insurance programs.

Job Summary

As a Customer Service Representative at blithequark, you will be responsible for handling daily member telephone calls, directing members to the proper services needed, educating members, problem-solving, and creating linkages to the Medical Management Department for authorization of services. You may also be responsible for assisting providers with eligibility, benefit, and resolution of claims issues.

Key Responsibilities:

• Respond to member inquiries via telephone, email, chat, and/or face-to-face, providing exceptional customer service and resolving concerns in a timely and professional manner.
• Educate members about our health plans, services, and benefits, and provide guidance on how to access care.
• Direct members to the proper services needed, including referrals to specialists, hospitals, and other healthcare providers.
• Collaborate with the Medical Management Department to obtain authorization for services, as needed.
• Assist providers with eligibility, benefit, and resolution of claims issues, ensuring accurate and timely processing.
• Maintain accurate and up-to-date knowledge of our health plans, services, and benefits.
• Participate in ongoing training and education to stay current with industry developments and best practices.

Qualifications

Required Qualifications:

• High School Diploma or equivalent certification.
• One (1) year of experience in a customer service-related role with direct contact with customers via telephone, email, chat, and/or face-to-face.

Preferred Qualifications:

• One (1) year of experience in a physician healthcare office environment or high-volume call center.
• One (1) year of experience and knowledge of HMO, PPO, TPA, PHO, and Managed Care functions.

Skills and Competencies

To succeed as a Customer Service Representative at blithequark, you will need:

• Excellent communication and interpersonal skills.
• Strong problem-solving and analytical skills.
• Ability to work in a fast-paced, dynamic environment.
• Strong attention to detail and accuracy.
• Ability to maintain confidentiality and handle sensitive information.
• Proficiency in Microsoft Office and other software applications.

Career Growth Opportunities and Learning Benefits

At blithequark, we are committed to the growth and development of our employees. We offer:

• Ongoing training and education to stay current with industry developments and best practices.
• Opportunities for career advancement and professional growth.
• A dynamic and supportive work environment that encourages collaboration and innovation.

Work Environment and Company Culture

At blithequark, we pride ourselves on a culture of high performance and a commitment to excellence. Our work environment is:

• Dynamic and fast-paced, with a focus on delivering exceptional service to our members.
• Collaborative and supportive, with a strong emphasis on teamwork and communication.
• Flexible and accommodating, with opportunities for remote work and flexible scheduling.

Compensation, Perks, and Benefits

We offer a comprehensive compensation package, including:

• Competitive salary and benefits.
• Opportunities for bonuses and incentives.
• A comprehensive benefits package, including medical, dental, and vision coverage.
• Paid time off and holidays.

Conclusion

If you are a motivated and compassionate individual with a passion for delivering exceptional customer service, we encourage you to apply for this exciting opportunity at blithequark. As a Customer Service Representative, you will play a vital role in providing exceptional service to our members and helping us achieve our mission of improving the lives of our members. Apply today and join our team!