Experienced Healthcare Customer Service Advisor for Remote Call Center Operations - Alabama

Introduction to blithequark

At blithequark, we are passionate about delivering exceptional customer experiences in the healthcare industry. As a leading provider of innovative IT solutions and services, we pride ourselves on our commitment to excellence and our dedication to making a positive impact on the lives of our clients and their members. With a global presence spanning multiple continents and 66 countries, we offer a dynamic and engaging work environment that fosters growth, learning, and career advancement. Our team of over 240,000 dedicated employees is the driving force behind our success, and we are now seeking talented individuals to join our ranks as Healthcare Customer Service Advisors in a remote call center setting.

Job Overview

In this critical role, you will serve as the primary point of contact for our members and healthcare providers, providing exceptional customer service and support for prior authorization creation and review of pending statuses. Your expertise will be instrumental in enrolling members into our Chronic Management Care (CMC) programs, which include cancer, kidney, artificial hearts, ortho, and other specialized care initiatives. As a Health Insurance Customer Service Advocate, you will be responsible for reviewing member policies, determining program eligibility, and coordinating appointments with providers. If you are a motivated and compassionate individual with a strong background in customer service and a passion for healthcare, we encourage you to apply for this exciting opportunity.

Primary Responsibilities

• Respond to inbound calls from members and healthcare providers, addressing their concerns and resolving issues in a timely and professional manner
• Ensure accurate and efficient case setup, documenting all required information and meeting production, quality, and regulatory expectations
• Review, research, and determine the appropriate course of action for each case, using available resources such as medical policies, standard operating procedures, and clinical guidelines
• Demonstrate proficiency and decision-making skills by solving complex problems and making informed decisions that align with our company's values and mission
• Make outbound calls to providers and/or members as needed to obtain additional information or coordinate care
• Maintain accurate and up-to-date records, using Microsoft Office applications such as Word, Excel, and Outlook to create and maintain documents, spreadsheets, and emails
• Adhere to all regulatory requirements, including HIPAA guidelines, and maintain confidentiality and discretion when handling sensitive member information
• Collaborate with internal stakeholders, including managers and directors, to ensure seamless operations and exceptional customer service

Essential Qualifications

• High School Diploma or GED (or higher), with documentation required for verification
• 2+ years of combined or related experience in healthcare administration, with a strong understanding of medical terminology
• 1+ year of call center experience, with a proven track record of providing exceptional customer service
• Proficiency with Microsoft Office applications, including Word, Excel, and Outlook
• Typing speed of 35+ words per minute, with accuracy and attention to detail
• Ability to follow a script for every call, with flexibility and adaptability in a fast-paced environment
• Dedicated work area established, separated from other living areas, with high-speed internet (20mbps upload/download speed) and compliance with HIPAA regulations
• Ability to work one of the varying shifts to support our 24/7 operations, with flexibility and a commitment to exceptional customer service

Preferred Qualifications

• Associate's Degree (or higher) in a healthcare-related field, with a strong foundation in medical terminology and healthcare administration
• Medical Terminology certification or equivalent experience, with a deep understanding of ICD-9/ICD-10 and CPT codes
• Previous experience in a healthcare call center or customer service environment, with a proven track record of providing exceptional service and support

Skills and Competencies

To be successful in this role, you will need to possess excellent communication and interpersonal skills, with the ability to build strong relationships with our members, healthcare providers, and internal stakeholders. You will also need to demonstrate strong problem-solving and analytical skills, with the ability to think critically and make informed decisions. Additionally, you will need to be proficient in Microsoft Office applications, with a strong foundation in medical terminology and healthcare administration.

Career Growth Opportunities and Learning Benefits

At blithequark, we are committed to the growth and development of our employees. As a Healthcare Customer Service Advisor, you will have access to a range of training and development programs, including on-the-job training, mentorship, and career advancement opportunities. You will also have the opportunity to work with a talented and dedicated team of professionals who are passionate about delivering exceptional customer service and making a positive impact on the lives of our members.

Work Environment and Company Culture

Our remote call center operations offer a flexible and dynamic work environment that is designed to support your success. You will have the opportunity to work from the comfort of your own home, with a dedicated work area that is separated from other living areas and compliant with HIPAA regulations. Our company culture is built on a foundation of excellence, integrity, and compassion, with a strong commitment to delivering exceptional customer service and making a positive impact on the lives of our members.

Compensation, Perks, and Benefits

We offer a competitive compensation package that includes a strong salary, benefits, and perks. As a Healthcare Customer Service Advisor, you will be eligible for a range of benefits, including medical, dental, and vision insurance, 401(k) matching, and paid time off. You will also have access to a range of perks, including flexible scheduling, remote work options, and opportunities for career advancement.

Conclusion

If you are a motivated and compassionate individual with a strong background in customer service and a passion for healthcare, we encourage you to apply for this exciting opportunity. As a Healthcare Customer Service Advisor at blithequark, you will have the opportunity to make a positive impact on 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 talented and dedicated team of professionals who are passionate about delivering exceptional customer service and making a difference in the lives of others. Apply today and take the first step towards a rewarding and challenging career with blithequark!