Experienced Healthcare Customer Service Member Advocate – Patient Advocacy and Care Coordination

At blithequark, we're dedicated to delivering innovative payment accuracy solutions that empower our clients to focus on what matters most – quality of care and healthier lives for all. As a premier independent healthcare payment integrity company in the US, we're committed to fostering an Ownership Culture that values People, Innovation, Integrity, Fun, and growth opportunities for our team members. We're seeking an experienced and compassionate Healthcare Customer Service Member Advocate to join our team. As a key member of our patient advocacy and care coordination team, you'll play a vital role in ensuring that our clients receive exceptional service and support. If you're passionate about delivering outstanding customer service, navigating complex healthcare systems, and making a meaningful difference in people's lives, we encourage you to apply for this exciting opportunity.

About the Opportunity

As a Healthcare Customer Service Member Advocate, you'll be the primary point of contact for health plan members, providing expert guidance and support to help them navigate the healthcare system. You'll work closely with medical professionals, case managers, and other stakeholders to coordinate care, resolve issues, and ensure that our clients receive the best possible outcomes.

Key Responsibilities

• Make outbound calls to members who have indicated perceived gaps in care, providing personalized support and guidance to help them access the resources they need.

• Take inbound calls, answering questions and addressing concerns regarding our programs, policies, and procedures.
• Provide benefit education to members, explaining copays, coinsurance, deductibles, in and out of network benefits, and formularies.
• Schedule follow-up times for additional care coordination management and/or community resource connections.
• Develop professional working relationships with colleagues, healthcare providers, and other contractors.
• Conduct critical due diligence follow-ups if additional research or action is required to resolve a member's concern or complaint.
• Enter and update all contact and activity information into our system, ensuring accurate and timely documentation.
• Notify management of any concerns, complaints, or suggestions for process improvements.
• Maintain a current knowledge of campaign regulations, policies, and procedures.
• Maintain current knowledge of all contract requirements and objectives.
• Maintain HIPAA Certification.
• Perform miscellaneous duties as assigned in a highly professional manner.

Essential and Preferred Qualifications

• At least 4 years of medical customer service experience.

• At least 1 year of medical claims processing and/or billing experience preferred.
• High School diploma or equivalent is required.
• Excellent verbal and written communication skills.
• Skilled in data entry and knowledge of computers.
• Courteous, professional, and respectful attitude.
• Strong understanding of customer service policies and processes.
• Member customer service background.
• Flexibility to handle any non-standard situations that may arise.
• Ability to multitask.

Skills and Competencies Required for Success

• Excellent communication and interpersonal skills.

• Strong problem-solving and critical thinking skills.
• Ability to work in a fast-paced environment with multiple priorities.
• Strong attention to detail and organizational skills.
• Ability to maintain confidentiality and handle sensitive information.
• Strong knowledge of healthcare systems, policies, and procedures.
• Ability to work collaboratively with cross-functional teams.
• Strong analytical and problem-solving skills.

Career Growth Opportunities and Learning Benefits

At blithequark, we're committed to investing in our team members' growth and development. As a Healthcare Customer Service Member Advocate, you'll have access to:

• Ongoing training and development opportunities to enhance your skills and knowledge.
• Mentorship and coaching from experienced professionals.
• Opportunities for career advancement and professional growth.
• A dynamic and supportive work environment that encourages collaboration and innovation.

Work Environment and Company Culture

We're proud to offer a dynamic and supportive work environment that values diversity, inclusion, and employee well-being. As a blithequark team member, you'll enjoy:

• A flexible and remote-friendly work environment.
• A comprehensive benefits package, including medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, paid family/parental leave, 11 paid holidays per year, and sick time and vacation time off annually.
• A commitment to work-life balance and employee well-being.
• Opportunities for professional growth and development.
• A dynamic and supportive work environment that encourages collaboration and innovation.

Compensation, Perks, and Benefits

We offer a competitive compensation package, including:

• $21.50/hour hiring range.
• Comprehensive benefits package, including medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, paid family/parental leave, 11 paid holidays per year, and sick time and vacation time off annually.
• Opportunities for professional growth and development.

How to Apply

If you're passionate about delivering exceptional customer service, navigating complex healthcare systems, and making a meaningful difference in people's lives, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, to [insert contact information]. We can't wait to hear from you!

Equal Opportunity Employer

blithequark is an equal opportunity employer and welcomes applications from diverse candidates. We're committed to creating a diverse and inclusive work environment that values and respects the contributions of all team members. Apply for this job