Experienced Reimbursement Specialist and Customer Service Representative for Healthcare Benefits Verification and Management

Introduction to blithequark

At blithequark, we are dedicated to delivering exceptional healthcare services that make a meaningful difference in the lives of our patients and clients. As a leader in the healthcare industry, we are committed to providing innovative solutions that ensure seamless and efficient healthcare benefits verification and management. We are now seeking an experienced Reimbursement Specialist and Customer Service Representative to join our team, working on a contract basis for a project that aims to reverify patient insurance benefits and ensure uninterrupted therapy.

Job Overview

This is a fully remote, contract role that requires the successful candidate to work from home, with the need to pick up and return equipment in Lake Mary, FL. The project is scheduled to start on December 1, 2024, and end on February 15, 2024, with a 40-hour workweek, Monday through Friday, between 8:00 AM and 8:00 PM EST. The selected candidate will be assigned a schedule, with a one-hour lunch break and adherence to assigned break schedules. Weekends may be required starting in January, with overtime available on a volunteer basis, subject to client approval.

Key Responsibilities

• Place outbound calls to verify patient insurance benefits, with a target of 35+ calls per day and 20 cases closed per day
• Contact insurance providers to verify information and confirm coverage changes
• Collect and review patient insurance benefit information, complete and submit insurance forms and prior authorizations in a timely manner, ensuring accuracy and adherence to third-party payer requirements
• Provide exceptional customer service to internal and external customers, resolving requests promptly and escalating complaints as needed
• Maintain regular phone contact with provider representatives, third-party customer service reps, and pharmacy staff, effectively communicating with payors for benefit investigations and coordinating with inter-departmental associates as necessary
• Process insurance and patient correspondence, report reimbursement trends or delays to the supervisor, and provide all necessary documentation for prior authorizations
• Analyze moderate scope problems within defined SOPs, exercising judgment to determine appropriate actions, and report all adverse events in line with training and SOP

Requirements and Qualifications

To be considered for this role, you must have:

• At least one year of experience in specialty pharmacy, medical insurance, healthcare setting, and/or related experience
• Patient and able to handle hold times of up to 90 minutes
• A private, designated workspace
• MS Office proficiency, including Excel, Outlook, and Word
• Flexibility in schedule and hours
• High school diploma or equivalent
• Employment verification for the last three employers
• Background check required

Preferred Qualifications

While not essential, the following qualifications are preferred:

• Experience in healthcare benefits verification and management
• Knowledge of insurance benefit management and reimbursement processes
• Excellent communication and customer service skills
• Ability to work in a fast-paced environment and meet productivity targets
• Strong analytical and problem-solving skills

Training and Development

The selected candidate will undergo approximately three weeks of training, which will consist of practice and mock calls, as well as hands-on learning of the CRM and specific client program protocol requirements. The training will be paid, and the candidate must meet the program score requirements by December 31, 2024.

What We Offer

At blithequark, we offer a competitive hourly rate of $18.00, with the potential to earn $19.00 per hour for candidates with two or more years of experience specific to healthcare benefits verification. We also provide a comprehensive training program, opportunities for career growth and development, and a dynamic and supportive work environment.

Company Culture and Work Environment

At blithequark, we pride ourselves on our company culture, which values innovation, teamwork, and exceptional customer service. We believe in creating a work environment that is supportive, inclusive, and empowering, where our employees can thrive and grow. As a remote worker, you will be an integral part of our team, working closely with colleagues and clients to deliver exceptional results.

Compensation, Perks, and Benefits

In addition to a competitive hourly rate, we offer a range of perks and benefits, including:

• Paid training and development opportunities
• Opportunities for career growth and advancement
• A dynamic and supportive work environment
• Flexible scheduling and remote work arrangements
• Comprehensive benefits package, including health, dental, and vision insurance
• 401(k) retirement plan and matching program
• Paid time off and holidays

How to Apply

If you are a motivated and experienced Reimbursement Specialist and Customer Service Representative looking for a new challenge, please apply for this exciting opportunity. To be considered, you must:

• Attend a position information session with Team Hiregy
• Sign a "Right to Represent" agreement to work with Hiregy on the project
• Complete a position requirements checklist and action items
• Participate in a Spark Hire one-way video interview
• Successfully complete all new hire requirements, including training and equipment pickup

Conclusion

At blithequark, we are committed to delivering exceptional healthcare services that make a meaningful difference in the lives of our patients and clients. If you are a dedicated and experienced Reimbursement Specialist and Customer Service Representative looking for a new challenge, we encourage you to apply for this exciting opportunity. Join our team and be part of a dynamic and supportive work environment that values innovation, teamwork, and exceptional customer service.