Experienced Customer Service Representative – TRICARE & Medicare Benefits Support

Are you passionate about delivering exceptional customer experiences and navigating complex inquiries with ease? Do you thrive in a fast-paced call center environment and enjoy the opportunity to learn and grow with a dynamic organization? If so, we invite you to join our team at blithequark as an Experienced Customer Service Representative, providing critical support to military members, retirees, and their dependents eligible for TRICARE and Medicare benefits.

About blithequark

As a leading not-for-profit health insurer and federal government contractor, blithequark has been making healthcare easier for the people we serve for nearly 80 years. With a strong commitment to our military and veteran community, we offer a range of health insurance plans, process claims, and provide customer support for beneficiaries of the Medicare program. Our team is dedicated to delivering exceptional service, and we're proud to be recognized for our culture and workplace excellence.

Key Responsibilities

As an Experienced Customer Service Representative, you will play a critical role in providing call center telephone support, responding to written inquiries, and assisting with claims and billing inquiries from hospitals and clinics. Your success will be measured by your ability to navigate multiple systems, research complex inquiries, and provide clear, accurate, and easy-to-understand responses. Key responsibilities include:

• Receiving telephone, written, fax, and e-mail inquiries concerning TRICARE eligibility, benefits determinations, and claims adjudication questions or billing problems
• Applying appropriate provisions of TRICARE regulations, interpretations, and procedural directives in making determinations on eligibility and benefits
• Obtaining and analyzing claims data to determine specific problem areas, including external communication to obtain data
• Completing research and providing final resolution to inquiries within contractual requirements
• Communicating with inquirers to determine appropriate authorization or referral of services
• Submitting claims for adjudication, correction, payment, or review as appropriate
• Educating providers on billing requirements of TRICARE to reduce claim problems
• Dealing tactfully with people in a wide variety of situations to convey a favorable corporate image
• Responding to inquirers using various forms of communication (written letter, telephone, web, or email) within time frames to exceed contractual standards
• Collecting and recording data for Customer Service records and computer analysis
• Informing supervisory staff of system problems when identified, researching problems to provide backup data and examples when needed

Essential Qualifications

To be successful in this role, you will need:

• U.S. citizenship (required due to Department of Defense restrictions)
• Must live within the vicinity of our Madison, WI campus location (45 miles from 1717 W. Broadway Madison, WI)
• High school diploma or equivalent
• 2 or more years of experience in customer service (call center)
• Ability to learn medical and insurance terminology
• Strong listening skills and ability to provide timely, accurate answers via telephone

Preferred Qualifications

While not required, we encourage candidates with:

• Expertise in Microsoft Office (Outlook, Word, Excel), internet, intranet, office equipment, and data entry
• Ability to navigate dual monitor screens and between multiple programs at once
• Strong skillsets in multi-tasking, research, and problem-solving
• Ability to work independently, deescalate situations with agitated individuals, control difficult situations, as well as influence and motivate others to comply with TRICARE procedures

Remote Work Requirements

As a remote worker, you will need:

• Wired (ethernet cable) internet connection from your router to your computer
• High-speed cable or fiber internet with a minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at https://speedtest.net)

Benefits

As a member of our team, you can expect:

• Competitive starting pay of $17.75/hour, plus a 2nd shift differential of $0.75/hour
• Performance bonus and/or merit increase opportunities
• 401(k) with dollar-per-dollar match up to 6% of salary (100% vested immediately)
• Competitive paid time off
• Health insurance, dental insurance, and telehealth services starting DAY 1
• Professional and Leadership Development Programs

Career Growth Opportunities

At blithequark, we're committed to helping our employees grow and develop their careers. As an Experienced Customer Service Representative, you'll have the opportunity to:

• Gain experience working in a call center environment
• Develop in-depth communication and customer service skills
• Work remotely from home
• Be part of a fun, supportive team that offers great advancement opportunities throughout the organization
• Contribute to a mission that serves our Nation's military, veterans, Guard and Reserves, and their families

Work Environment and Company Culture

Our Madison, WI campus location offers a dynamic and supportive work environment, with a strong focus on employee engagement and empowerment. We're proud of our recognition for culture and workplace excellence, and we're committed to creating an open and inclusive workplace where everyone can thrive.

How to Apply

If you're passionate about delivering exceptional customer experiences and navigating complex inquiries with ease, we invite 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 Opportunity Employer/Protected Veterans/Individuals with Disabilities

blithequark is an equal opportunity employer and welcomes applications from diverse candidates. We're committed to creating an inclusive workplace where everyone can thrive. Apply for this job