Experienced Customer Service Representative – Medicare Appeal Process Support (Remote)

At blithequark, we're dedicated to empowering better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. As a Customer Service Representative, you'll play a vital role in supporting our Medicare Appeal process, ensuring that our customers receive exceptional service and timely resolutions to their inquiries.

Join Our Team of Passionate Individuals

At blithequark, we're more than just a company – we're a community of passionate individuals dedicated to making a difference in the lives of our customers. Our Lead the Way philosophy encourages you to take ownership of your work, actively engage in problem-solving, and drive innovation in everything you do. With unparalleled opportunities for growth and development, you'll have the chance to accelerate your career and make a meaningful impact in the healthcare industry.

Job Summary

As a Customer Service Representative, you'll be responsible for supporting the Medicare Appeal process by answering incoming telephone calls, resolving customer questions, complaints, and requests, and adhering to internal policies and procedures. This is a remote position, offering the flexibility to work from the comfort of your own home.

Key Responsibilities

* Develop and maintain working knowledge of internal policies, procedures, and services (both departmental and operational)

• Utilize automated systems to log and retrieve information, and perform accurate and timely data entry of electronic faxes
• Receive inquiries from customers or providers by telephone, email, fax, or mail, and communicate responses within required turnaround times
• Respond to telephone inquiries and complaints in a prompt, accurate, and courteous manner, following standard operating procedures
• Interact with hospitals, physicians, beneficiaries, or other program recipients
• Investigate and resolve or report customer problems, identifying and escalating difficult situations to the appropriate party
• Meet or exceed standards for call volume and service level per department guidelines
• Initiate files by collecting and entering demographic, provider, and procedure information into the system
• Serve as liaison between the Review Supervisors and external providers
• Maintain logs and documents disposition of incoming and outgoing calls

Requirements

* High School diploma or equivalent

• 2+ years of customer service/telephone experience in a similar call center environment and/or industry
• Ability to effectively communicate with team members and external customers
• Ability to research and resolve issues related to Medicaid program and service eligibility
• Bilingual (Spanish/English)

Preferred Qualifications/Experience

* Previous experience in the medical office or other medical setting

• General knowledge of eligibility verification (Medicaid eligibility and program requirements for specific program of focus)
• Knowledge of CPT and HCPCS codes
• PC proficiency to include Microsoft Office Suite
• Experience with Microsoft programs

Benefits

At blithequark, we're committed to providing a comprehensive benefits package that supports your career growth and overall well-being. Our benefits include:

• Comprehensive health plans
• Paid time off
• Retirement savings
• Corporate wellness
• Educational assistance
• Corporate discounts
• And more!

Compensation

The pay range for this position is $15.85 - $18.20, based on our compensation program, which considers various factors such as years of applicable experience and skill level.

Why Join Our Team?

At blithequark, we're a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. We're a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

How to Apply

If you're passionate about delivering exceptional customer service and making a difference in the lives of our customers, we encourage you to apply for this exciting opportunity. Please visit our website at blithequark.com/careers/ to submit your application.

Equal Opportunity Employer

blithequark is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law.

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