Introduction to blithequark
At blithequark, we share a singular, clear purpose: bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-driven healthcare for a rapidly changing world. Embedded in our brand — with heart at its center — our motivation sends a personal message that how we deliver our services is just as important as what we deliver. We are dedicated to making healthcare more personal, convenient, and affordable.
Our Heart At Work Behaviors
Our Heart At Work Behaviors support this purpose. We want every individual who works at blithequark to feel empowered by the role they play in transforming our culture and accelerating our ability to grow and deliver solutions to make healthcare more accessible. We strive to create an environment where our employees can thrive and make a meaningful difference in the lives of our customers.
Job Overview
The Customer Service Representative is the face of blithequark and impacts customers' service experience by handling customer service requests and issues via phone, web, or written correspondence. Customer requests are of essential and sometimes complex nature. The successful candidate will engage, consult, and educate customers based on their unique needs, preferences, and understanding of blithequark plans, tools, and resources to help guide them along a path to care.
Key Responsibilities
- Respond to questions and resolve issues based on calls/letters from customers, providers, and plan sponsors.
- Escalate emergencies to appropriate staff and record and track contacts with customers, providers, and plan sponsors.
- Guide customers through their 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 customers by understanding and engaging the customer to the fullest to support their best health.
- Take ownership to understand the customer's needs by building a trusting and caring relationship with the customer completely.
- Anticipate customer needs and provide the customer with relevant information to address unasked questions, such as additional plan details, benefit plan details, customer self-service tools, etc.
- Utilize customer support limit system to make financial decisions to resolve customer issues.
- Explain customer limitations as per contract.
- Process claim referrals, new case handoffs, nurse reviews, complaints (customer/provider), and appeals (customer/provider) via target system.
- Educate providers on our self-service options and assist providers 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 verify customer plan eligibility related to incoming communication and internal referrals.
- Handle incoming requests for authorizations and pre-approvals not handled by Clinical Case Management.
- Perform review of customer 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
- Bachelor's degree required.
- 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 is necessary.
- Ability to multitask to efficiently accomplish tasks.
- Understanding of medical terminology.
- Strong oral and written communication skills.
- Proficient in Microsoft Word and Outlook.
- Ability to maintain accuracy and production standards.
- Excellent communication and interpersonal skills.
- Technical skills and problem-solving abilities.
- Attention to detail and accuracy.
Preferred Qualifications
- Prior experience in a customer-facing role, preferably in a healthcare or insurance setting.
- Knowledge of healthcare plans, policies, and procedures.
- Experience with customer relationship management (CRM) software.
- Certification in customer service or a related field.
Career Growth Opportunities and Learning Benefits
At blithequark, we are committed to the growth and development of our employees. We offer a range of training programs, workshops, and conferences to help our employees enhance their skills and knowledge. Our employees have access to a variety of career paths and opportunities for advancement, and we encourage internal mobility and promotions.
Work Environment and Company Culture
Our work environment is dynamic, fast-paced, and collaborative. We value diversity, equity, and inclusion, and we strive to create a workplace where everyone feels welcome, valued, and respected. Our company culture is built on our Heart At Work Behaviors, which emphasize empathy, compassion, and a commitment to delivering exceptional customer service.
Compensation, Perks, and Benefits
We offer a competitive salary range of $30-$41 per hour, depending on experience and qualifications. Our employees are also eligible for a range of benefits, including medical, dental, and vision insurance, a 401(k) retirement savings plan, and a employee stock purchase plan. We also offer a range of wellness programs, education assistance, and free development courses to help our employees achieve their personal and professional goals.
Conclusion
If you are a motivated and compassionate individual who is passionate about delivering exceptional customer 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 helping us achieve our mission to make healthcare more personal, convenient, and affordable. Don't miss out on this chance to make a difference in the lives of our customers and to grow and develop your career with a leading healthcare organization.
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