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Experienced Special Needs Healthcare Customer Advisor - National Remote Opportunity

Remote · Ethiopia Full-time

At blithequark, we're simplifying the healthcare experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the healthcare system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us and start doing your life's best work.

  • *About blithequark**

blithequark is a leading healthcare organization dedicated to providing innovative solutions that improve the lives of our members. Our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone – of every race, gender, sexuality, age, location, and income – deserves the opportunity to live their healthiest life. Our commitment to diversity, equity, and inclusion drives our work, and we strive to create a workplace that reflects the communities we serve.

  • *About the Role**

We're seeking an experienced Special Needs Healthcare Customer Advisor to join our team of highly skilled Care Advisors. As a Special Needs Healthcare Customer Advisor, you will have the opportunity to deliver an extraordinary experience to family members who need an ally. You will be empowered to fast-track resolutions and serve as an ongoing resource to provide guidance and community resources during key transition times throughout the family's journey. Some of the issues you will help resolve include complex benefits, claim and billing issues, prior authorizations, appeals, and more.

  • *Key Responsibilities**

• Provide holistic family support to members who may have special needs themselves or may be caring for children or family members with special needs, owning end-to-end resolution of issues.

  • Serve as an ongoing, point of contact for members, primarily via the phone channel (may also use email, chat, text), delivering compassionate support to members, creating a memorable, positive experience.
  • Create and build ongoing relationships with others, including both members and teammates.
  • Make decisions independently and solve problems creatively and completely using sound judgment and critical thinking.
  • Consistently follow through on commitments and framing realistic expectations for members.
  • Plan, prioritize, organize, and complete work to meet established objectives for our families.
  • Responsible for managing project time to ensure follow-up and outreach work is completed in a timely manner.
  • Families served include a range of low, moderate, and high needs as determined by clinical needs, financial impacts, and/or level of escalation.
  • Process includes outreach calls to initiate contact with members referred by executives and partners.
  • Responsible for maintaining accurate family counts on our documentation platform.
  • Focus on teamwork and fostering a strong team environment through activities, including mentoring and acting as a resource for colleagues.
  • Anticipate member needs and proactively seek out external and internal resources or partners where appropriate to add unexpected value for the member.
  • Determine appropriate referrals to other programs/services as needed with or without technology guidance.
  • Responsible for providing high-quality member experience as reflected in post-contact surveys and member feedback.
  • *Essential Qualifications**

• High School Diploma / GED OR equivalent work experience

  • 1+ years of experience helping, resolving, or advocating on behalf of members or customers
  • Experience using a computer and Microsoft Office, including Microsoft Word (create correspondence and work within templates), Microsoft Excel (ability to sort, filter, and create simple spreadsheets), and Microsoft Outlook (email and calendar management)
  • Ability to work 40 hours per week, Monday through Friday, from 9:45am – 6:15pm CST, within our Family Engagement Center. It may be necessary, given the business need, to work occasional overtime.
  • Must be 18 years of age or older
  • *Preferred Qualifications**

• 1+ years of A4Me OR 3+ months of Quick Assist experience

  • Claims processing experience
  • Experience providing care for children with special needs
  • Experience within a member-focused healthcare environment
  • Experience within a service delivery capacity (examples include, but are not limited to: social services, caregivers, hospitality, social work, sales, non-profit agencies)
  • *Telecommuting Requirements**

• Ability to keep all company-sensitive documents secure (if applicable)

  • Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
  • Must live in a location that can receive a blithequark-approved high-speed internet connection or leverage an existing high-speed internet service.
  • *Compensation and Benefits**

We offer a comprehensive benefits package, including a competitive salary, incentive and recognition programs, equity stock purchase, and 401(k) contribution (al

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