Experienced Customer Service Representative – Remote Full-Time Opportunity with Competitive Hourly Rate at arenaflex

Introduction to arenaflex At arenaflex, we share a singular, clear purpose: bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-driven healthcare for a rapidly changing world. Embedded in our brand — with heart at its center — our motivation sends a personal message that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose, empowering each individual who works at arenaflex to feel enabled by the role they play in transforming our culture and accelerating our ability to grow and deliver solutions to make healthcare more personal, convenient, and affordable. Job Overview We are seeking an experienced Customer Service Representative to join our team at arenaflex. As the face of our organization, you will influence our members' service experience by handling customer care requests and issues via phone, web, or written correspondence. Your role will be to engage, consult, and educate our members based on their unique needs, preferences, and understanding of arenaflex plans, tools, and resources to guide them along a path to care. Key Responsibilities Respond to questions and resolve issues based on calls/letters from members, providers, and plan sponsors. Escalate emergencies to appropriate staff and record and track contacts with members, providers, and plan sponsors. Guide members through their individual plan of benefits, arenaflex policy, and procedures, as well as being knowledgeable about resources to comply with any regulatory requirements. Make a personal connection with our members by understanding and engaging the member to the fullest to support their best health. Take ownership to understand the member's needs by building a trusting and caring relationship with the member completely. Anticipate customer needs and provide the customer with relevant information to address unasked questions, such as additional plan details, benefit plan details, member self-service tools, etc. Utilize customer support limit framework to make financial decisions to resolve member issues. Explain member limitations as per contract. Process claim referrals, new case handoffs, nurse reviews, complaints (member/provider), and appeals (member/provider) via target system. Educate providers on our self-service options and assist providers with credentialing and re-credentialing issues. Answer demands received from arenaflex's Regulation Record Place regarding litigation and claims, and handle broad document review demands. Aid in the preparation of complaint pattern reports and assist with integrating claim data for customer reviews. Determine clinical needs, relevant coverage policies, and verify member plan eligibility related to incoming communication and internal referrals. Handle incoming requests for authorizations and pre-approvals not handled by Clinical Case Management. Perform review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible. Perform financial data entry as needed. Utilize relevant system tools and resources to generate quality letters and spreadsheets in response to requests received. Essential Qualifications To be successful in this role, you will need: A Bachelor's Degree. Customer service experience in a transaction-based environment, such as a call center or retail store, with a proven ability to be empathetic and compassionate. Experience in a production environment. Ability to multitask to efficiently accomplish tasks. Understanding of medical terminology. Effective oral and written communication skills. Proficiency with Microsoft Word and Outlook. Ability to maintain accuracy and production standards. Excellent communication and interpersonal skills. Technical skills. Problem-solving abilities. Attention to detail and accuracy. Preferred Qualifications While not required, the following qualifications are preferred: Previous experience in a healthcare or insurance setting. Knowledge of arenaflex plans, tools, and resources. Experience with customer relationship management (CRM) software. Bilingual or multilingual skills. Career Growth Opportunities and Learning Benefits At arenaflex, we are committed to the growth and development of our employees. As a Customer Service Representative, you will have access to a range of training and development opportunities to help you build your skills and advance your career. These may include: Comprehensive training programs to help you develop your customer service and communication skills. Opportunities to specialize in specific areas of customer service, such as claims or billing. Leadership development programs to help you build your management and leadership skills. Access to online courses and educational resources to help you continue your education and stay up-to-date with industry trends. Work Environment and Company Culture At arenaflex, we are proud of our company culture and the values that guide our behavior. As a Customer Service Representative, you will be part of a dynamic and supportive team that is committed to delivering exceptional customer service. Our company culture is built on the following values: A passion for customer service and a commitment to delivering exceptional experiences. A collaborative and supportive team environment. A focus on continuous learning and development. A commitment to diversity, equity, and inclusion. Compensation, Perks, and Benefits As a Customer Service Representative at arenaflex, you will be eligible for a range of compensation, perks, and benefits, including: A competitive hourly rate of $30-$41 per hour. A comprehensive benefits package, including medical, dental, and vision coverage. A 401(k) retirement savings plan with company match. A range of wellness programs and employee discounts. Paid time off and holidays. Conclusion If you are a motivated and customer-focused individual who is looking for a challenging and rewarding role, we encourage you to apply for this opportunity. As a Customer Service Representative at arenaflex, you will be part of a dynamic and supportive team that is committed to delivering exceptional customer service. You will have access to a range of training and development opportunities to help you build your skills and advance your career. Apply now to join our team and take the first step towards a rewarding and challenging career in customer service. Apply for this job