Experienced Remote Healthcare Customer Service Representative - Utilization Review and Coordinated Care Specialist

Introduction to blithequark

At blithequark, we are dedicated to delivering exceptional healthcare services that make a meaningful difference in the lives of our members. As a leader in the healthcare industry, we strive to provide innovative solutions, outstanding customer service, and unparalleled support to our patients and communities. We are now seeking an experienced and compassionate Remote Healthcare Customer Service Representative to join our team, working from the comfort of their own home. If you are passionate about healthcare, have excellent communication skills, and are committed to providing top-notch customer service, we encourage you to apply for this exciting opportunity.

Job Overview

In this critical role, you will be responsible for assisting in activities related to the medical and psychological aspects of utilization and coordinated care. You will work closely with our team to ensure that our members receive the best possible care, while also providing exceptional customer service and support. As a Remote Healthcare Customer Service Representative, you will be the primary point of contact for our members, responding to their inquiries, addressing their concerns, and providing them with timely and accurate information.

Key Responsibilities

• Assist in activities related to the medical and psychological aspects of utilization and coordinated care, including outreach attempts via telephone to members assigned each day
• Consistently update an Excel spreadsheet with member assignments listed, ensuring accuracy and attention to detail
• Maintain consistent communication with your supervisor, providing updates on your progress and seeking guidance as needed
• Document each phone call in Virtual Health, ensuring that all interactions are thoroughly recorded and up-to-date
• Make a high volume of outbound calls to our Medicare population, with a goal of completing 80-120 phone calls per day
• Ensure compliance with all assigned members, achieving a compliance rate of 100%
• Achieve an engagement rate of 80% or more per month, demonstrating your ability to effectively connect with our members and provide them with valuable support

Essential Qualifications

• 2-3 years of experience in a managed care setting, medical office, or facility setting, with demonstrated medical administration duties
• Thorough knowledge of customer service, utilization review, or claims processing practices in a managed care environment
• Operation of office equipment, including a personal computer, and proficiency in Microsoft Office
• Knowledge of medical terminology, with the ability to understand and communicate complex medical concepts
• Excellent time management and organizational skills, with the ability to prioritize tasks and manage multiple responsibilities
• Strong communication skills, both written and verbal, with the ability to effectively interact with members, supervisors, and other stakeholders
• High school diploma or equivalent required, with a basic knowledge of Microsoft Office and Excel

Preferred Qualifications

• Experience working in a remote or home-based environment, with a proven ability to work independently and manage your time effectively
• Knowledge of HIPAA regulations and guidelines, with a commitment to maintaining confidentiality and upholding the highest standards of integrity
• Experience working with Medicare populations, with a understanding of their unique needs and challenges
• Strong analytical and problem-solving skills, with the ability to think critically and outside the box

Skills and Competencies

To be successful in this role, you will need to possess a unique combination of skills and competencies, including:

• Excellent communication skills, with the ability to effectively interact with members, supervisors, and other stakeholders
• Strong analytical and problem-solving skills, with the ability to think critically and outside the box
• Ability to work independently, with a proven ability to manage your time effectively and prioritize tasks
• Knowledge of medical terminology, with the ability to understand and communicate complex medical concepts
• Proficiency in Microsoft Office, including Excel, with the ability to update spreadsheets and maintain accurate records

Career Growth Opportunities and Learning Benefits

At blithequark, we are committed to providing our employees with opportunities for growth and development, both personally and professionally. As a Remote Healthcare Customer Service Representative, you will have access to a range of training and development programs, including:

• Comprehensive onboarding program, designed to ensure your success in the role
• Ongoing training and development opportunities, including workshops, webinars, and online courses
• Opportunities for advancement, including promotions and lateral moves within the company
• A supportive and collaborative work environment, with a team of experienced professionals who are dedicated to helping you succeed

Work Environment and Company Culture

At blithequark, we pride ourselves on our positive and supportive work environment, which is built on a foundation of respect, empathy, and inclusivity. As a Remote Healthcare Customer Service Representative, you will be working from the comfort of your own home, with the flexibility to create your own schedule and work at times that are most convenient for you. You will also be part of a dynamic and collaborative team, with opportunities to interact with colleagues and supervisors through regular virtual meetings and online forums.

Compensation, Perks, and Benefits

We offer a competitive compensation package, including a pay rate of $20.00 per hour, as well as a range of perks and benefits, including:

• Comprehensive health insurance, including medical, dental, and vision coverage
• 401(k) retirement plan, with company match
• Paid time off, including vacation days, sick leave, and holidays
• Opportunities for professional development and growth, including training and education programs

Conclusion

If you are a motivated and compassionate individual who is passionate about healthcare and customer service, we encourage you to apply for this exciting opportunity. As a Remote Healthcare Customer Service Representative at blithequark, you will have the chance to make a meaningful difference in the lives of our members, while also advancing your career and developing your skills and expertise. Don't miss out on this opportunity to join our team and start making a positive impact today!