**Experienced Full Stack Customer Service Representative – Healthcare Industry**

Are you a compassionate and detail-oriented individual with a passion for delivering exceptional customer service? Do you have a strong understanding of the healthcare industry and its complexities? If so, we invite you to join blithequark, a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. **About the Role:** As a Customer Service Representative at blithequark, you will play a vital role in providing top-notch support to our clients and their members. You will be responsible for handling inbound and outbound calls, responding to member and provider inquiries with professionalism and accuracy. Your expertise in healthcare terminology, including ICD-9 and ICD-10 coding, will enable you to navigate complex claims and benefits processes with ease. **Remote Position in Georgia:** We are seeking a highly motivated and organized individual to join our team in a 100% remote position based in Georgia. As a remote employee, you will enjoy a predictable schedule, allowing you to maintain a healthy work-life balance. Our remote team is dedicated to delivering exceptional service to our clients, and we are looking for someone who shares our commitment to excellence. **What We Offer:** * Genuine work/life balance – a predictable schedule * Paid training period * Comprehensive benefits package, including medical, dental, life, vision, HSA, and 401K * Paid time off (PTO) * Opportunities for career growth and professional development * Collaborative and dynamic work environment **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. **COMPANY OVERVIEW:** blithequark is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. We provide claims processing services, including digital transformation, claims adjudication, and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans' members and providers. The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement, and satisfaction with plans' members and providers. We process millions of claims and multiples of related structured and unstructured data elements within these claims annually. Our innovative workflow technology platform, JetStreamTM, helps with traceability, governance, and automation of claims operations for our clients. blithequark is headquartered in Tampa, operates 10 regional offices throughout the U.S., and has a wholly owned global delivery center in the Philippines. **Equal Employment Opportunity:** blithequark provides equal employment opportunities to all employees and applicants for employment 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. **How to Apply:** If you are a motivated and detail-oriented individual with a passion for delivering exceptional customer service, we invite you to apply for this exciting opportunity. Please visit our website to submit your application and join our team at blithequark. Apply Job! Apply for this job