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

Introduction to blithequark

At blithequark, we are dedicated to providing 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 delivering innovative solutions that ensure seamless and efficient healthcare benefits verification and management. Our team of experienced professionals is passionate about providing top-notch customer service, and we are now seeking a highly skilled Reimbursement Specialist to join our dynamic team.

Job Overview

We are looking for a talented and experienced Reimbursement Specialist to work on a contract, project basis, starting from December 1, 2024, and ending on February 15, 2024. As a Reimbursement Specialist, you will play a critical role in verifying patient insurance benefits, ensuring that healthcare providers have up-to-date information about patient insurance coverage, and guaranteeing that they receive appropriate reimbursement for their services. This is a fully remote position, with the requirement to pick up and return equipment in Lake Mary, FL.

Key Responsibilities

• Place outbound calls to verify patient insurance benefits, with a target of 35+ calls per day and 20 cases or more closed per day
• Contact insurance providers to verify information and confirm coverage changes
• Collect and review patient insurance benefit information according to program SOPs
• 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 communicate with payors for benefit investigations and coordinate 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 successful in this role, you must have:

• At least 1 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 by client requirements
• A private, designated workspace
• MS Office proficiency, including Excel, Outlook, and Word
• Flexibility in schedule and hours
• High school diploma or equivalent
• Employment verification required for the last 3 employers
• Background check required

Preferred Qualifications

While not required, the following qualifications are preferred:

• 2+ years of experience specific to healthcare benefits verification, which may qualify for a higher hourly rate of $19.00
• Experience working in a call center environment
• Knowledge of healthcare insurance benefits and reimbursement processes
• Excellent communication and customer service skills

Skills and Competencies

To excel in this role, you must possess:

• Strong analytical and problem-solving skills
• Excellent communication and customer service skills
• Ability to work in a fast-paced environment and meet productivity targets
• Strong attention to detail and ability to maintain accuracy in a high-volume environment
• Ability to work independently and as part of a team

Career Growth and Learning Opportunities

At blithequark, we are committed to providing our employees with opportunities for growth and development. As a Reimbursement Specialist, you will have access to:

• Comprehensive training program, including approximately 3 weeks of training, with practice and mock calls
• Ongoing coaching and feedback to help you succeed in your role
• Opportunities for professional development and advancement within the company

Work Environment and Company Culture

At blithequark, we pride ourselves on our dynamic and supportive work environment. As a remote employee, you will be part of a virtual team that values collaboration, open communication, and mutual respect. We offer a flexible and autonomous work environment that allows you to work independently and manage your time effectively.

Compensation and Benefits

We offer a competitive hourly rate of $18.00, with the potential to earn $19.00 per hour for candidates with 2+ years of experience specific to healthcare benefits verification. Additionally, you will have access to a range of benefits, including:

• Paid training and professional development opportunities
• Flexible scheduling and remote work arrangements
• Opportunities for overtime and career advancement

Conclusion

If you are a motivated and experienced Reimbursement Specialist looking for a new challenge, we encourage you to apply for this exciting opportunity. At blithequark, we are committed to providing exceptional healthcare services, and we believe that our team members are our greatest asset. Join our dynamic team and take the first step towards a rewarding and challenging career in healthcare benefits verification and management.

To apply, please follow the link to our application portal and complete the required steps, including a position information session, candidate sign "Right to Represent," and a Spark Hire one-way video interview. We look forward to hearing from you and exploring how you can contribute to our team's success.