**Experienced Healthcare Customer Service Representative – Remote Georgia Position**

Are you passionate about delivering exceptional customer service and making a positive impact on people's lives? Do you have a strong understanding of the healthcare industry and its complexities? If so, we invite you to join blithequark's dynamic team as a Remote Healthcare Customer Service Representative in Georgia. **About blithequark** blithequark is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. With a strong commitment to excellence, we strive to enhance engagement and satisfaction with plans' members and providers. Our innovative workflow technology platform, JetStreamTM, helps us deliver efficient and effective claims processing services to our clients. **Join Our Team** As a Remote Healthcare Customer Service Representative, you will play a vital role in taking member services calls related to policy management, benefits, and claim inquiries. You will be a valued member of our team, providing exceptional customer service to our clients and members by ensuring their satisfaction on calls. This position requires a solid understanding of the healthcare claims, benefits, and policy process flows, as well as expertise in healthcare terminology, including ICD-9 and ICD-10 coding. **Key Responsibilities** * Member and Provider Support: Manage inbound and outbound calls, responding to member and provider inquiries with professionalism and accuracy. Provide information on membership options, benefits, and account status on behalf of our clients. * Application Processing: Review, verify, and process membership applications efficiently, ensuring completeness and accuracy of all required information. * Data Entry and Management: Maintain and update member information in our CRM systems, ensuring data integrity and accuracy across multiple client accounts. * Multitasking: Handle multiple client accounts and responsibilities simultaneously, managing calls, processing paperwork, and updating databases without compromising on quality. * Quality Assurance: Perform regular audits of member data to ensure compliance with client standards and industry regulations, identifying and rectifying any discrepancies. * Collaboration: Coordinate with other teams within blithequark, including IT, customer service, and quality assurance, to resolve issues and enhance service delivery for our clients. * Process Improvement: Continuously identify opportunities to streamline processes and contribute to initiatives that improve client satisfaction and operational efficiency. **Job Description** * Handle Inbound Calls: Receive and respond to calls primarily from members, providers, and occasionally other health plans. Provide information on the status of authorization requests, including both inpatient and outpatient services. * Authorization Management: Address and manage re-direct requests. Handle requests to re-fax authorization documents as needed. * Extensive Claims Denial: Deep understanding and description of claims and claims denials. * Lines of Business: General Membership, Health Plan Providers, ETC. * Documentation and Compliance: Accurately document call interactions and outcomes in the appropriate systems. Ensure compliance with all relevant regulations and guidelines. * Customer Service: Maintain a high level of professionalism and customer service in all interactions. Resolve issues promptly and effectively, ensuring customer satisfaction. **Qualifications** * Educational Background: High school diploma or equivalent * Technical Skills: + Proficiency in Microsoft Office Suite (Word, Excel, Outlook) + Experience with CRM systems or membership databases + Strong typing and data entry skills, with the ability to manage multiple systems simultaneously * Other Qualifications: + Attention to Detail: Keen ability to detect and correct errors in data, ensuring high standards of accuracy and consistency. + Multitasking Ability: Proven track record of effectively managing multiple tasks and priorities in a busy work environment. + Communication Skills: Excellent verbal and written communication skills, with the ability to articulate information clearly and confidently to members. + Problem-Solving Skills: Strong analytical capabilities with a focus on identifying issues and implementing solutions quickly and effectively. + Customer Service Orientation: A passion for delivering exceptional service to clients and their members, aligning with blithequark's commitment to excellence. **What We Offer** * Genuine work/life balance - a predictable schedule * Paid training period * Medical, Dental, Life, Vision, HSA, 401K * PTO * Opportunities for career growth and professional development * Collaborative and dynamic work environment * Recognition and rewards for outstanding performance **Work Environment and Company Culture** blithequark is committed to creating a positive and inclusive work environment that values diversity, equity, and inclusion. We believe in fostering a culture of open communication, collaboration, and continuous learning. Our team members are passionate about delivering exceptional service and making a positive impact on people's lives. **Compensation and Benefits** * Salary: $17.00 - $19.00 per hour * Benefits: Medical, Dental, Life, Vision, HSA, 401K * PTO: Generous paid time off policy * Opportunities for career growth and professional development **How to Apply** If you are a motivated and customer-focused individual with a passion for delivering exceptional service, we invite you to apply for this exciting opportunity. Please submit your application through our website, and we will review your qualifications and experience. **Equal Employment Opportunity** blithequark is an equal employment opportunity employer and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. **Apply Now** Don't miss this opportunity to join a dynamic team and make a positive impact on people's lives. Apply now to become a Remote Healthcare Customer Service Representative at blithequark. Apply for this job