Job Description:Join blithequark in Revolutionizing Customer ServiceAt blithequark, we're not just looking for a customer service representative – we're seeking a passionate and dedicated individual who shares our commitment to delivering exceptional customer experiences. As a Customer Service Representative, you'll be the face of our company, interacting with customers through various channels to resolve their queries, complaints, and concerns. If you're a people person with a knack for problem-solving and a passion for delivering top-notch service, we want to hear from you!About blithequarkblithequark is a leading healthcare company that's dedicated to transforming the way we deliver healthcare services. Our purpose is simple: to bring our heart to every moment of your health. We believe that how we deliver our services is just as important as what we deliver, and that's why we're committed to creating a culture that's centered around empathy, compassion, and innovation.Our Heart At Work BehaviorsAt blithequark, we're guided by our Heart At Work Behaviors, which support our purpose and drive our commitment to delivering exceptional customer experiences. These behaviors include:* Empowering our employees to take ownership of their work and make a meaningful impact* Fostering a culture of innovation and creativity* Prioritizing diversity, equity, and inclusion* Embracing change and adapting to new challenges* Delivering results that exceed expectationsAbout the RoleAs a Customer Service Representative, you'll be responsible for:* Maintaining a positive, empathetic, and professional attitude toward customers at all times* Responding promptly to customer inquiries and resolving their queries and complaints* Communicating with customers through various channels, including phone, email, and chat* Processing orders, forms, applications, and requests* Keeping records of customer interactions, transactions, comments, and complaints* Communicating and coordinating with colleagues as necessary* Providing feedback on the efficiency of the customer service processResponsibilities* Answer questions and resolve issues based on phone calls/letters from members, providers, and plan sponsors* Triages resulting rework to appropriate staff* Provide excellent customer services for high volume in-bound provider calls for the Claims Inquiry/Claims Research team* Extensive claims research on multiple platforms to assist providers with payment questions* Provides the customer with related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc.* Uses customer service threshold framework to make financial decisions to resolve member issues* Explains member's rights and responsibilities in accordance with contract* Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system* Educates & assists providers on our self-service options* Assists providers with credentialing and re-credentialing and contracting questions and issues* Assists in compiling claim data for customer audits* Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referralsRequirements* Must live in the state of Oklahoma full-time* Familiarity with Microsoft Office products* Experience in highly transactional call center environment* Excellent customer service and critical thinking* High speed internet access (25 mbps or higher) and consistent connection* Work location must be set up with a direct connection to the router (NOT Wi-Fi)* We provide a 6 ½ foot long ethernet cord, if the distance is further, you will be required to provide your own ethernet cableEducation* High School diploma or GED equivalentWork Schedule* This is a remote work opportunity, and you must be able to work from home* Must be able to attend 4 weeks of training (virtual) between the hours of 8-5 CST* After training, the permanent schedule is an Monday-Friday and can start as early as 7 am CST and end as late as 7 pm CSTWhy Join blithequark?* Competitive compensation and benefits package* Opportunities for career growth and professional development* Collaborative and dynamic work environment* Recognition and rewards for outstanding performance* Comprehensive training and support to ensure your successHow to ApplyIf you're a motivated and customer-focused individual who is passionate about delivering exceptional service, we encourage you to apply for this exciting opportunity. Please submit your application through our website, and we'll be in touch to discuss your qualifications further.Equal Employment Opportunityblithequark is an equal employment opportunity employer and welcomes applications from diverse candidates. We are committed to creating a workplace that is inclusive and respectful of all employees, and we strive to provide equal opportunities for employment and advancement.Disability Accommodationsblithequark is committed to providing reasonable accommodations to applicants with disabilities. If you require a reasonable accommodation during the application process, please contact us at [insert contact information].Application DeadlineApplications will be accepted on a rolling basis until the position is filled. We encourage you to apply early to ensure consideration.Thank You for Your InterestWe appreciate your interest in joining blithequark as a Customer Service Representative. We look forward to reviewing your application and discussing your qualifications further.Apply for this job