Experienced Medical Claims Customer Service Representative – Remote Healthcare Professional for Exceptional Patient Experience

Welcome to blithequark

At blithequark, we are a pioneering, data-driven healthcare organization that is committed to operational excellence and making high-quality healthcare affordable for all. Our mission is built around 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. Led by a team of visionary physicians, we empower our partners to deliver exceptional healthcare, prioritizing outcomes and value for all patients. As a leader in the healthcare industry, blithequark is dedicated to advancing value-based healthcare and supporting the well-being of our employees and their families.

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 exceptional customer service skills will be crucial in providing courteous and professional service while handling various tasks and projects, including mailing assistance. You will be the voice of blithequark, making a positive impact on the lives of our clients and members by delivering outstanding customer service and addressing inquiries related to claims payment, status, and coverage information.

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, providing courteous and professional support to clients and members.
• Address inquiries related to claims payment, status, and coverage information, interpreting client health plan protocols and providing clear explanations.
• Assist with claims processing tasks, including reports and workflow queues, to ensure efficient and effective claims management.
• Document calls accurately and maintain high professionalism, adhering to blithequark's quality standards and security policies.
• Return incoming calls and perform additional duties as assigned, demonstrating flexibility and a commitment to exceptional customer service.

What You'll Need to Succeed

To be successful in this role, you will need:

• 1 to 3 years of customer service experience in healthcare, with a strong understanding of healthcare claims processing and the ability to interpret client health plan protocols.
• Experience in a high-volume call center, with excellent verbal and written communication skills and the ability to work effectively in a fast-paced environment.
• Background in healthcare or health insurance, with familiarity with BCBS HMOI or other insurance plans being a plus.
• Proficiency in Microsoft Office and multiple systems, with the ability to learn and adapt to new technologies and systems.
• Availability for an 8-hour shift between 8 AM and 6 PM Central Time, with flexibility to work varying shifts as needed.

What We'd Love to See

In addition to the essential qualifications, we would love to see:

• Experience with HMO Managed Care and Medicare Advantage, with a strong understanding of the complexities of healthcare claims processing and management.
• Advanced knowledge of healthcare claims processing and management, with the ability to analyze complex data and provide insights to improve claims management processes.
• Certifications or training in customer service, healthcare, or a related field, demonstrating a commitment to ongoing learning and professional development.

Benefits and Compensation

At blithequark, we are committed to supporting our employees and their families with a comprehensive range of benefits, including:

• Work from Home: Enjoy the flexibility of a fully remote position, reducing commute time and allowing you to focus on your professional and personal goals.
• Health Coverage: Comprehensive Medical, Dental, and Vision plans to keep you and your family well-covered.
• Retirement Planning: Our 401(k) plan includes a 3% employer match on your 6% contribution, helping you plan for a secure financial future.
• Peace of Mind: Life and Disability insurance, with optional additional coverage for you and your loved ones, providing peace of mind and financial security.
• Support During Tough Times: Access our Employee Assistance Program (EAP) for extra support and resources to help you navigate challenging situations.
• Flexible Time Off: Tailored PTO to help you achieve work-life balance and meet personal goals, with paid parental leave to support you when welcoming a new family member.
• Professional Growth: Resources and opportunities dedicated to your career development, helping you grow and succeed in your role and beyond.

The base pay range for this role is between $18.45 and $20.50 per hour, paid bi-weekly, with final pay rates based on factors such as skill set, relevant experience, education, location, and certifications.

Equal Opportunity Employment

At blithequark, we are committed to diversity, inclusion, and belonging, and we make employment decisions without regard to race, religion, color, age, sex, sexual orientation, gender identity, national origin, citizenship, marital status, familial status, disability, military or veteran status, pregnancy, or any other protected status. We ensure fair treatment in all aspects of employment and are an equal opportunity employer.

Security Policies

This role involves adhering to all security policies and procedures to protect all PHI and intellectual properties, with specific responsibilities for security-related roles defined by the hiring manager.

Employment Type

This is a full-time position, offering a unique opportunity to join a dynamic and growing team of healthcare professionals who are passionate about delivering exceptional customer service and advancing value-based healthcare.

Conclusion

If you are a motivated and customer-focused individual with a passion for healthcare and exceptional customer service, we encourage you to apply for this exciting opportunity to join the blithequark team. As a Medical Claims Customer Service Representative, you will play a critical role in delivering outstanding customer service and supporting the well-being of our clients and members. With a comprehensive range of benefits, opportunities for professional growth, and a commitment to diversity and inclusion, blithequark is the ideal place to build a rewarding and challenging career in healthcare. Apply now to take the first step towards an exciting and fulfilling career with blithequark!