**Experienced Provider Customer Service Representative – Delivering Exceptional Support to Healthcare Professionals**

Are you a customer service professional with a passion for delivering exceptional support to healthcare providers? Do you thrive in a fast-paced, dynamic environment where no two calls are ever the same? If so, we invite you to join blithequark's team of dedicated professionals who are committed to providing world-class service to our valued provider partners. At blithequark, we understand the importance of building strong relationships with our healthcare providers. Our Provider Customer Service Representatives play a critical role in ensuring that our providers receive the support and guidance they need to deliver high-quality care to their patients. As a key member of our team, you will be responsible for answering questions, resolving issues, and providing education and assistance to our providers through phone calls, letters, and other communication channels. **Key Responsibilities:** * Answer questions and resolve issues based on phone calls/letters from providers, utilizing your excellent critical thinking and problem-solving skills to provide timely and effective solutions * Provide exceptional customer service to high-volume inbound provider calls, ensuring that every interaction is positive, professional, and respectful * Conduct extensive claims research on multiple platforms, using your analytical skills to identify and resolve complex issues * Utilize the customer service threshold framework to make informed financial decisions, ensuring that our providers receive fair and accurate compensation for their services * Process claim referrals, new claim handoffs, nurse reviews, and provider complaints, maintaining accurate records and ensuring timely resolution * Educate and assist providers on our self-service options, empowering them to take control of their interactions with us * Determine medical necessity, applicable coverage provisions, and verify member plan eligibility, ensuring that our providers have the information they need to deliver high-quality care * Perform review of member and provider claim history, identifying trends and areas for improvement **Requirements:** * Familiarity with Microsoft Office products, including Word, Excel, and Outlook * Excellent computer skills, including the ability to navigate multiple screens and systems simultaneously * Experience working in a highly transactional call center environment, with a proven track record of delivering exceptional customer service * Strong critical thinking and problem-solving skills, with the ability to analyze complex issues and develop effective solutions * Secure, private home office location with high-speed internet access (100 mbps or higher) * Ability to work independently, with minimal supervision, and as part of a remote team **Benefits:** * Full range of medical, dental, and vision benefits, ensuring that you and your loved ones receive the care you need * 401(k) retirement savings plan, helping you build a secure financial future * Employee Stock Purchase Plan, giving you the opportunity to invest in your future with blithequark * Fully-paid term life insurance, providing peace of mind and financial security for your loved ones * Short-term and long-term disability benefits, ensuring that you receive the support you need in the event of an illness or injury * Well-being programs, promoting your physical and mental health and well-being * Education assistance, helping you develop new skills and advance your career * Free development courses, empowering you to take control of your professional growth and development * CVS store discount, giving you access to exclusive savings and discounts * Paid Time Off (PTO), allowing you to recharge and refocus * Paid holidays, ensuring that you have time to relax and celebrate with your loved ones **Why Join blithequark?** At blithequark, we are committed to creating a workplace culture that is inclusive, supportive, and empowering. We believe that our employees are our greatest asset, and we are dedicated to providing them with the tools, resources, and opportunities they need to succeed. As a member of our team, you will have the opportunity to: * Work with a talented and diverse team of professionals who are passionate about delivering exceptional service to our providers * Develop new skills and advance your career through our comprehensive training and development programs * Enjoy a competitive salary and benefits package, including a full range of medical, dental, and vision benefits * Take advantage of our flexible work arrangements, including remote work options and flexible scheduling * Participate in our well-being programs, promoting your physical and mental health and well-being * Enjoy exclusive discounts and savings through our CVS store discount program **How to Apply:** If you are a customer service professional with a passion for delivering exceptional support to healthcare providers, we invite you to apply for this exciting opportunity. Please submit your resume and a cover letter outlining your experience, skills, and qualifications. We look forward to hearing from you!