Customer Service Representative - Remote Quality Improvement and Care Management

Join the Mission to Revolutionize Healthcare with Arsenault Are you a motivated and customer-focused professional looking for a new challenge in the healthcare industry? Do you value care management and quality improvement? Are you excited about the opportunity to make a real difference in the lives of individuals across the country? If so, we invite you to join our team as a Customer Service Representative at Arsenault, a rapidly growing national quality improvement and care management organization. About Us At Arsenault, we are driven by a mission to improve lives through healthcare quality and clinical expertise. We work tirelessly to ensure that over 20 million people receive the right care, at the right time, in the right setting. Our organization is built on a foundation of people-focused values, and we are committed to providing our employees with the training and support they need to succeed. Our Culture and Values We pride ourselves on being a people-focused and mission-driven organization. Our culture is built on values of compassion, empathy, and excellence. We believe in fostering a work environment that is inclusive, supportive, and empowering. Our employees are our greatest asset, and we are committed to providing them with the resources and opportunities they need to grow and thrive. Our Commitment to Diversity and Inclusion At Arsenault, we are committed to creating a diverse and inclusive work environment. We believe that a diverse workforce brings different perspectives, ideas, and experiences that help us better serve our customers and communities. We are an Equal Opportunity Employer and welcome applications from qualified candidates of all backgrounds. The Role As a Customer Service Representative at Arsenault, you will play a critical role in supporting the prior authorization process by answering incoming telephone calls, resolving customer questions, complaints, and requests while adhering to internal policies and procedures. You will utilize your working knowledge of our organization's services to meet productivity and quality standards. Key Responsibilities Develop and maintain working knowledge of internal policies, procedures, and services (both departmental and operational) Utilize automated systems to log and retrieve information, and perform accurate and timely data entry of electronic faxes Receive inquiries from customers or providers by telephone, email, fax, or mail, and communicate responses within required turnaround times Respond to telephone inquiries and complaints in a prompt, accurate, and courteous manner, following standard operating procedures Interact with hospitals, physicians, beneficiaries, or other program recipients Investigate and resolve or report customer problems, and identify and escalate difficult situations to the appropriate party Meet or exceed standards for call volume and service level per department guidelines Initiate files by collecting and entering demographic, provider, and procedure information into the system Serve as a liaison between Review Supervisors and external providers Maintain logs and documents disposition of incoming and outgoing calls What You'll Need Required Qualifications High School diploma or equivalent Medical terminology course(s) helpful Knowledge, Skills, and Abilities Knowledge of: Medical terminology Health insurance industry Ability to: Speak English fluently enough to be clearly understood over the telephone Use phone system effectively Research and investigate Follow confidentiality policies and procedures Navigate and use electronic equipment and systems easily and proficiently Multitask on a personal computer while conducting telephone conversations Work in a fast-paced call center environment Remain calm and courteous when handling difficult calls and requests Skills: Bilingual Spanish-English a plus Effective verbal and listening skills to provide courteous and professional customer service Effective PC skills, including electronic mail, intranet, and industry-standard applications Experience We are looking for candidates with 2+ years of customer service/telephone experience in a similar call center environment and/or industry. Benefits and Perks At Arsenault, we offer a comprehensive benefits package designed to provide you and your family with additional protection, security, and support for both your career and your life away from work. Our benefits include: Comprehensive health plans Paid time off Retirement savings Corporate wellness programs Educational assistance Corporate discounts and more Career Growth Opportunities and Learning Benefits At Arsenault, we are committed to providing our employees with opportunities for growth and development. We offer: Comprehensive training programs Career advancement opportunities Professional development workshops and seminars Mentorship programs Work Environment and Company Culture We pride ourselves on being a people-focused and mission-driven organization. Our culture is built on values of compassion, empathy, and excellence. We believe in fostering a work environment that is inclusive, supportive, and empowering. Remote Work Opportunities As a Customer Service Representative at Arsenault, you will have the opportunity to work remotely from the comfort of your own home. We provide our remote employees with the tools and support they need to succeed, including: State-of-the-art technology and equipment Comprehensive training programs Regular check-ins and feedback Why Join Us? If you are a motivated and customer-focused professional looking for a new challenge in the healthcare industry, we invite you to join our team at Arsenault. We offer: A comprehensive benefits package Opportunities for career growth and development A supportive and inclusive work environment The chance to make a real difference in the lives of individuals across the country How to Apply If you are excited about the opportunity to join our team as a Customer Service Representative, please submit your application through our website. We look forward to hearing from you! Arsenault is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Apply for this job