Experienced Customer Service Representative – Remote Work Opportunity for Delivering Exceptional Health Care Support

Introduction to arenaflex At arenaflex, we are driven by a singular purpose: to bring our heart to every moment of your health. This guiding principle underscores our commitment to delivering human-centric health care that is both personal and innovative. As a leader in the health care industry, arenaflex is dedicated to making health care more accessible, convenient, and affordable for all. Our brand, with heart at its core, reflects our dedication to the well-being of our customers and the communities we serve. Our Culture and Values arenaflex's Heart At Work Behaviors support our overarching purpose and empower every team member to play a vital role in transforming our culture and driving innovation. We believe that how we deliver our services is just as important as what we deliver, and we strive to create an environment where every employee feels valued, supported, and inspired to make a difference. By joining arenaflex, you will become part of a dynamic team that is passionate about delivering exceptional health care support and making a positive impact on people's lives. Job Overview We are seeking an experienced Customer Service Representative to join our team and provide outstanding support to our customers. As a Customer Service Representative, you will be the primary point of contact for our members, providers, and plan sponsors, answering questions, resolving issues, and delivering exceptional customer service. This is a remote work opportunity, and you will be required to attend 7 weeks of virtual training with no absences during that time. After completing the training, you will work a permanent schedule from Monday to Friday, starting as early as 7 am CST and ending as late as 7 pm CST. Key Responsibilities Answer questions and resolve issues based on phone calls/letters from members, providers, and plan sponsors, and triage resulting rework to appropriate staff. Provide excellent customer service for high-volume inbound provider calls for the Claims Inquiry/Claims Research team, and conduct extensive claims research on multiple platforms to assist providers with payment questions. Provide customers with related information to answer unasked questions, such as additional plan details, benefit plan details, member self-service tools, and more. Use the customer service threshold framework to make financial decisions to resolve member issues, and explain members' rights and responsibilities in accordance with their contract. Process claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via the target system. Educate and assist providers on our self-service options, and help with credentialing and re-credentialing and contracting questions and issues. Assist in compiling claim data for customer audits, determine medical necessity, applicable coverage provisions, and verify member plan eligibility relating to incoming correspondence and internal referrals. Requirements and Qualifications To be successful in this role, you will need to meet the following requirements: Be available to work between 7 am-7 pm, Monday to Friday. Have familiarity with Microsoft Office products. Have experience in a highly transactional call center environment. Possess excellent customer service and critical thinking skills. Have a high-speed internet connection (25 mbps or higher) and a consistent connection, with a work location set up with a direct connection to the router (NOT Wi-Fi). Have a High School diploma or GED equivalent. Preferred Qualifications While not required, the following qualifications are preferred: Previous experience in a health care or insurance-related field. Knowledge of claims processing and insurance terminology. Experience with customer service software and technology. Skills and Competencies To excel in this role, you will need to possess the following skills and competencies: Excellent communication and interpersonal skills. Strong problem-solving and critical thinking skills. Ability to work in a fast-paced environment and prioritize tasks effectively. 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 Development 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, including: Comprehensive training programs to help you develop your skills and knowledge. Opportunities for career advancement and professional growth. Access to a range of development courses and educational resources. Work Environment and Company Culture arenaflex is a dynamic and supportive work environment that values diversity, equity, and inclusion. We believe in creating a workplace culture that is inclusive, respectful, and empowering, where every employee feels valued and supported. As a remote worker, you will be part of a virtual team that is connected and collaborative, with regular opportunities for communication and feedback. Compensation and Benefits arenaflex offers a competitive compensation package, including a pay range of $17.00 - $25.65 per hour. In addition to your compensation, you will also be eligible for a range of benefits, including: Medical, dental, and vision benefits. 401(k) retirement savings plan. Employee Stock Purchase Plan. Term life insurance plan. Short-term and long-term disability benefits. Well-being programs and education assistance. CVS store discount and discount programs with participating partners. Paid Time Off (PTO) or vacation pay, and paid holidays throughout the calendar year. Conclusion If you are a motivated and customer-focused individual who is passionate about delivering exceptional health care support, we encourage you to apply for this exciting opportunity. As a Customer Service Representative at arenaflex, you will be part of a dynamic team that is dedicated to making a positive impact on people's lives. Don't miss out on this chance to join a leading health care organization and take your career to the next level. Apply now to become part of the arenaflex team! Apply for this job