Experienced Healthcare Customer Service Member Advocate – Delivering Exceptional Support and Care Coordination to Health Plan Members at blithequark

Introduction to blithequark At blithequark, we are dedicated to making a positive impact in the lives of our clients and their members by providing innovative payment accuracy solutions. As a leader in the healthcare payment integrity industry, we strive to deliver exceptional services that enable our clients to focus on what matters most – quality care and healthier lives for all. Our mission is built on a foundation of people, innovation, integrity, fun, and an ownership culture that empowers our team members to make a difference. If you are passionate about healthcare and customer service, and you are looking for a dynamic and supportive work environment, then blithequark is the perfect place for you. About the Opportunity We are seeking a highly skilled and compassionate Healthcare Customer Service Member Advocate to join our team. As a Member Advocate, you will be the primary point of contact for health plan members, providing exceptional support and care coordination to ensure that their needs are met. This is a fantastic opportunity to make a real difference in the lives of our members and to be part of a team that is dedicated to delivering outstanding customer service. The hiring range for this position is $21.50 per hour, and we offer a wide range of benefits to support a healthy work-life balance, including medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, paid family/parental leave, and 11 paid holidays per year. Key Responsibilities As a Healthcare Customer Service Member Advocate at blithequark, your key responsibilities will include: Making outbound calls to members who have indicated perceived gaps in care to provide support and coordination Taking inbound calls, answering questions, and documenting communication to ensure that member needs are met Providing benefit education to members, including explaining copays, coinsurance, deductibles, in and out of network benefits, and formularies Scheduling follow-up times for additional care coordination management and/or community resource connections Developing professional working relationships with colleagues, healthcare providers, and other contractors to ensure seamless care coordination Conducting critical due diligence follow-ups to resolve member concerns or complaints Entering and updating all contact and activity information into our system to ensure accurate and timely documentation Notifying management of any issues or concerns, including member dissatisfaction, legal action, government intervention, or suggestions for process improvements Maintaining a current knowledge of campaign regulations, policies, and procedures to ensure compliance and excellence in customer service Maintaining HIPAA certification to ensure the confidentiality and integrity of member data Essential and Preferred Qualifications To be successful in this role, you will need: At least 4 years of medical customer service experience, with a strong understanding of customer service policies and processes Excellent verbal and written communication skills, with the ability to communicate complex information in a clear and concise manner Skilled in data entry and knowledge of computers, with the ability to navigate multiple systems and software applications Courteous, professional, and respectful attitude, with a strong commitment to delivering exceptional customer service Flexibility to handle non-standard situations that may arise, with a strong ability to multitask and prioritize tasks effectively High school diploma or equivalent is required, with at least 1 year of medical claims processing and/or billing experience preferred Skills and Competencies To excel in this role, you will need to possess the following skills and competencies: Strong understanding of healthcare terminology and concepts, including medical billing and claims processing Excellent problem-solving and analytical skills, with the ability to resolve complex issues and concerns Strong communication and interpersonal skills, with the ability to build rapport with members, healthcare providers, and other stakeholders Ability to work in a fast-paced environment, with a strong ability to prioritize tasks and manage multiple projects simultaneously Strong attention to detail, with a commitment to accuracy and quality in all aspects of work Career Growth Opportunities and Learning Benefits At blithequark, we are committed to the growth and development of our team members. As a Healthcare Customer Service Member Advocate, you will have access to a wide range of training and development opportunities, including: Comprehensive onboarding program to ensure a smooth transition into the role Ongoing training and development opportunities to enhance skills and knowledge Opportunities for career advancement and professional growth within the company Recognition and reward programs to recognize and reward outstanding performance and contributions Work Environment and Company Culture At blithequark, we are proud of our dynamic and supportive work environment, which is built on a foundation of people, innovation, integrity, fun, and an ownership culture. As a team member, you can expect: A collaborative and inclusive work environment that values diversity and promotes equality A strong commitment to work-life balance, with flexible scheduling and remote work options available A comprehensive benefits package that includes medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, and more A recognition and reward program that recognizes and rewards outstanding performance and contributions Compensation, Perks, and Benefits At blithequark, we offer a competitive compensation package that includes: A hourly rate of $21.50 per hour A comprehensive benefits package that includes medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, and more 11 paid holidays per year, plus sick time and vacation time off annually A recognition and reward program that recognizes and rewards outstanding performance and contributions Conclusion If you are a compassionate and skilled customer service professional who is passionate about healthcare, then we encourage you to apply for this exciting opportunity to join our team as a Healthcare Customer Service Member Advocate. At blithequark, we are committed to delivering exceptional customer service and making a positive impact in the lives of our members. We look forward to hearing from you and exploring how you can contribute to our mission and values.