**Experienced Customer Experience Representative III (Remote) – Member and Provider Support**

Are you passionate about delivering exceptional customer experiences and making a meaningful impact in the lives of individuals and healthcare providers? Do you thrive in a fast-paced, dynamic environment where no two days are ever the same? If so, we invite you to join our team at blithequark as an Experienced Customer Experience Representative III (Remote) – Member and Provider Support. **About blithequark** blithequark is a leading healthcare organization dedicated to providing high-quality, patient-centered care to millions of individuals across the United States. Our mission is to improve the health and well-being of our members, while also supporting the healthcare providers who care for them. We're committed to innovation, collaboration, and excellence in everything we do. **Job Summary** As an Experienced Customer Experience Representative III (Remote) – Member and Provider Support, you will play a critical role in delivering exceptional customer experiences to our members and healthcare providers. You will be responsible for resolving issues, addressing needs, and providing product and service information in a fair and effective manner. You will also identify opportunities to improve our member and provider experiences, and work collaboratively with other departments to achieve our goals. **Key Responsibilities** * Provide service support to members and/or providers using one or more contact center communication channels, including phone, chat, email, and off-phone work, across multiple states and/or products. * Handle escalated calls on behalf of management, providing excellent customer service for all call center communication channels. * Accurately document all member/provider communication, and maintain confidentiality and discretion when handling sensitive information. * Work regularly scheduled shifts within our hours of operation, including lunches and breaks, and be available to work overtime and/or weekends as needed. * Demonstrate a strong ability to build rapport and respond to customers in a compassionate manner, identifying and exceeding customer expectations. * Listen skillfully, collect relevant information, determine immediate requests, and identify the customer's needs. * Achieve individual performance goals established for this position in the areas of call quality, attendance, and scheduled adherence. * Engage and collaborate with other departments, including sales, marketing, and operations. * Demonstrate personal responsibility and accountability by taking ownership of the call/issue and following it through to resolution, on behalf of the customer, in real time or through timely follow-up with the customer. * Support member needs for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other areas, including complex issues. * Support provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing, and other areas, including complex issues. * Proficient in three or more lines of business (e.g., Medicare, Medicaid, Marketplace, MMP) for members services, provider services, and member retention. * Respond to incoming calls from providers on a variety of issues of varying complexity, including highly complex or executive issues. * Complete research for state, legislative, or regulatory inquiries as applicable. * Gather information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions. * Achieve individual performance goals as it relates to call center objectives. * Proactively engage and collaborate with other departments as required. * Demonstrate personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations. * Assist with formal training needs of other employees, including new hire or training classes as needed. * Support provider and member needs for a wide variety of inquiries involving member eligibility, and covered benefits. * Provide inquiry assistance involving claims, authorizations, appeals, contracting, credentialing, and other provider-related issues. * Support other inquiry areas, including complex issues. * Conduct initial research and work to immediately resolve issues. * Appropriately escalate issues based on established risk criteria. * Recommend and implement programs to support member needs. * Resolve member inquiries and complaints fairly and effectively to ensure member retention. * Respond to incoming calls from members and providers. * Conduct member satisfaction assessment services and other member surveys as applicable and based on business needs. * Assist other retention or inbound functions as dictated by service level requirements. * Remain professional and courteous in verbal and written communications, utilizing concise and effective language at all times. **Essential Qualifications** * Associate's Degree or equivalent combination of education and experience. * 3-5 years of customer service or sales experience in a fast-paced, high-volume environment. * Proficient in Microsoft Office, Genesys, Salesforce, Pega, QNXT, CRM, Verint, Kronos, Microsoft Teams, Video Conferencing, CVS Caremark, Availity, and Molina Provider Portal. * Strong communication and interpersonal skills, with the ability to build rapport and respond to customers in a compassionate manner. * Ability to work in a team environment, with a focus on collaboration and problem-solving. * Strong analytical and problem-solving skills, with the ability to critically evaluate options and develop solutions. * Ability to work in a fast-paced, dynamic environment, with a focus on meeting deadlines and achieving goals. **Preferred Qualifications** * Bachelor's Degree or equivalent combination of education and experience. * 5-7 years of customer service or sales experience in a fast-paced, high-volume environment. * Broker/Healthcare insurance licensure. * Experience working in a healthcare environment, with a focus on customer service and member/provider support. **Career Growth Opportunities and Learning Benefits** At blithequark, we're committed to helping our employees grow and develop their careers. We offer a range of training and development opportunities, including: * Formal training programs, including new hire training and ongoing education and development. * Mentorship and coaching programs, to help you achieve your career goals. * Opportunities for advancement, including promotions and career progression. * A culture of innovation and experimentation, where you can try new things and take calculated risks. **Work Environment and Company Culture** We're proud of our company culture, which is built on a foundation of: * Collaboration and teamwork. * Innovation and experimentation. * Customer focus and member satisfaction. * Diversity, equity, and inclusion. * Employee well-being and work-life balance. **Compensation, Perks, and Benefits** We offer a competitive benefits and compensation package, including: * A salary range of $13.41 - $29.06 per hour, based on experience and qualifications. * Comprehensive health insurance, including medical, dental, and vision coverage. * 401(k) retirement plan, with company match. * Paid time off, including vacation, sick leave, and holidays. * Flexible work arrangements, including remote work options. * Professional development opportunities, including training and education. **How to Apply** If you're passionate about delivering exceptional customer experiences and making a meaningful impact in the lives of individuals and healthcare providers, we invite you to apply for this exciting opportunity. Please submit your application, including your resume and cover letter, through our online application system. **Equal Opportunity Employer** blithequark is an Equal Opportunity Employer (EOE), committed to diversity, equity, and inclusion. We welcome applications from diverse candidates, including individuals with disabilities, veterans, and members of underrepresented groups. Apply for this job