Experienced Customer Service Representative - Health Plan Services at blithequark

Join blithequark: Delivering Exceptional Customer Experiences in Healthcare

At blithequark, one of the fastest-growing Independent Physician Associations in Southern California, we're revolutionizing the healthcare landscape. Our mission is to provide high-quality, patient-centered care, and we're seeking a skilled Customer Service Representative to join our dynamic team. As a key member of our Member Services team, you'll be the face of blithequark, ensuring a seamless and positive experience for our members and Health Plans.

About the Role

As a Customer Service Representative at blithequark, you'll be responsible for providing top-notch administrative support and resolving customer inquiries via phone, email, or other channels. Your exceptional communication skills, empathy, and problem-solving abilities will be essential in addressing the diverse needs of our members and Health Plans. You'll work in a fast-paced environment, handling multiple tasks and prioritizing your work to maintain a high level of productivity.

Key Responsibilities

• Respond to incoming calls from members and Health Plans, providing information and clarification on RMG/LMG services, such as authorizations, member billing, referrals, and eligibility.
• Maintain or exceed quality and productivity standards, handling a minimum of 35 calls per day with accurate documentation.
• Anticipate and address member needs, utilizing standardized processes and tools, such as EZCAP 6X and REA/LEA Systems.
• Resolve routine or complex issues related to services received within the medical group, including eligibility, authorization status, provider access issues, and member billing.
• Document all interactions in the EZCAP 6X customer service module and REA/LEA systems.
• Provide essential information to members regarding authorizations, billing issues, eligibility, and urgent cares.
• Maintain patient confidentiality, following HIPAA and PHI processes.
• Ensure department compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations.
• Access Interpretation language line for non-English patients as needed.
• Demonstrate professionalism, a warm and pleasant phone personality, and excellent judgment.
• Prioritize work, manage your workflow, and maintain a high level of productivity.

Requirements and Qualifications

To succeed in this role, you'll need:

• A minimum of 2 years of customer service experience, preferably in a healthcare setting.
• Multi-line telephone experience and excellent communication skills, both verbal and written.
• A High School Diploma or equivalent.
• The ability to deal responsibly with confidential matters and maintain patient confidentiality.
• Proficient typing skills (45 WPM) with accuracy.
• Strong organizational skills, with an emphasis on prioritizing and attention to detail.
• Knowledge of MS Office programs (Word, Excel, Outlook, Access, and PowerPoint).
• Familiarity with computers, faxes, printers, and other office equipment.
• The ability to review and interpret health plan benefits and provider contracts.

Preferred Qualifications

• Experience working in a fast-paced, dynamic environment.
• Knowledge of CPT, HCPCS, and other healthcare-related codes.
• Previous experience with customer service software and technology.

What We Offer

At blithequark, we're committed to providing a comprehensive benefits package that supports the well-being of our employees. Our benefits include:

• Competitive hourly rate ($20-$21 per hour).
• A sign-on bonus and discretionary awards.
• Medical, pharmacy, and dental insurance.
• Vision insurance and zero co-payments for employed physician office visits.
• Flexible Spending Account (FSA) and Employer-Paid Life Insurance.
• Employee Assistance Program (EAP) and Behavioral Health Services.
• 401(k) Retirement Savings Plan and Income Protection Insurance.
• Vacation time, sick days, paid holidays, and mileage reimbursement.
• Tuition Reimbursement and License Renewal CEU Cost Reimbursement Program.
• A business-casual working environment and opportunities for career growth.

Career Growth and Development

At blithequark, we're dedicated to nurturing the growth and development of our employees. As a Customer Service Representative, you'll have opportunities to:

• Develop your skills in a fast-paced, dynamic environment.
• Take on new challenges and responsibilities.
• Advance your career within the organization.
• Participate in training and development programs.

Our Culture

At blithequark, we pride ourselves on our welcoming and supportive work environment. We promote teamwork, encourage learning, and foster a culture of excellence. Our employees are our greatest asset, and we're committed to providing a work environment that is inclusive, engaging, and rewarding.

Join Our Team

If you're a motivated and compassionate customer service professional looking for a new challenge, we want to hear from you. Apply now to join our team at blithequark and be part of a dynamic organization that's shaping the future of healthcare.

As an equal opportunities employer, blithequark considers qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.

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