Experienced Remote Customer Service Representative – Health Plan Call Center Expertise for arenaflex

Introduction to arenaflex and the Industry arenaflex is a leading provider of health plan services, dedicated to delivering exceptional support to its members, providers, and their representatives. As a key player in the healthcare industry, arenaflex recognizes the importance of compassionate and knowledgeable customer service representatives who can provide clear and concise assistance to those in need. With a strong commitment to excellence and a passion for making a positive impact, arenaflex is seeking dedicated and empathetic Customer Service Representatives (CSRs) to join its health plan call center team. Job Overview This is a fully remote position, offering the flexibility and convenience of working from the comfort of your own home. With a preference for candidates located in the PST time zone, this role is ideal for individuals who can work later shifts and are committed to providing exceptional support to health plan members and providers. As a CSR at arenaflex, you will play a vital role in managing inbound inquiries, conducting outbound calls, and addressing questions related to health plan benefits, claims, eligibility, billing, and more. Key Responsibilities Answer and manage inbound inquiries about health plan benefits, claims, eligibility, and related topics, providing clear, concise, and compassionate assistance to members and providers. Conduct outbound or return calls as needed, ensuring that all interactions are handled in a professional and empathetic manner. Document relevant information clearly and concisely in computer systems, maintaining accurate and up-to-date records. Communicate complex healthcare-related information in simple, understandable terms, ensuring that members and providers have a clear understanding of their benefits and options. Handle customer complaints and grievances with empathy and effective conflict management skills, resolving issues in a fair and timely manner. Meet performance goals related to efficiency, accuracy, quality, member satisfaction, and attendance, consistently striving for excellence in all aspects of your role. Adhere to all applicable department, organization, and regulatory policies and procedures, ensuring compliance with HIPAA and other relevant regulations. Requirements and Qualifications To be successful in this role, you will need to possess a combination of skills, experience, and personal qualities that enable you to provide exceptional customer service and support. The essential requirements for this position include: High school diploma or GED, demonstrating a strong foundation in education and a commitment to learning. Minimum of 1 year of call center experience, preferably in a health plan or related environment, with a proven track record of providing excellent customer service and support. Ability to handle 50-100 calls daily, maintaining a high level of productivity and efficiency in a fast-paced environment. Proficiency with computers and Microsoft applications, including strong keyboard and navigation skills, with the ability to type at least 35 WPM. Availability to work scheduled shifts and overtime as needed, demonstrating flexibility and a commitment to meeting the needs of the team and the organization. Ability to maintain confidentiality of protected health information (HIPAA compliance), ensuring the security and integrity of sensitive data. Preferred Qualifications In addition to the essential requirements, the following qualifications are preferred: 2+ years of experience in a health plan, TPA, or related call center, with a deep understanding of managed care, Commercial, Marketplace, Medicaid, and/or Medicare programs. Knowledge of managed care, Commercial, Marketplace, Medicaid, and/or Medicare programs, with the ability to apply this knowledge in a practical and effective manner. Bilingual in Spanish & English (validated via bilingual assessment upon offer acceptance), enabling you to provide support to a diverse range of members and providers. At Home Workspace Requirements To ensure your success in this role, you will need to have a dedicated and private workspace that meets the following requirements: A quiet, private workspace free from noise and distractions, enabling you to focus on your work and provide exceptional customer service. Dedicated workspace within your home, outside of common areas, with a secure and reliable internet connection. Resolved dependent and/or pet care arrangements during working hours, ensuring that you can work without interruptions or distractions. Workspace must ensure privacy and confidentiality of HIPAA/PHI information, with measures in place to protect sensitive data and maintain confidentiality. Working from public places or outside the country is not permitted, as this may compromise the security and integrity of sensitive data. Technology Requirements To perform your role effectively, you will need to have access to the following technology: Smartphone for accessing Microsoft Multi-Factor Authentication & Microsoft Teams, enabling you to stay connected and communicate with the team. High-speed internet service (100 MBPS fiber optic) with direct router connection via Ethernet cord, providing a fast and reliable connection. Incompatible internet services: 4G, 5G, LTE, or Satellite, as these may not provide the necessary speed or reliability for your role. Company-Supplied Equipment arenaflex will provide you with the following equipment to support your role: Dell Laptop/Small PC (depending on inventory), enabling you to perform your duties efficiently and effectively. Power cords, one large monitor, keyboard, mouse, headset, and 15-foot Ethernet cable, providing you with the necessary tools and equipment to succeed in your role. Career Growth Opportunities and Learning Benefits At arenaflex, we are committed to the growth and development of our employees, providing opportunities for learning, training, and career advancement. As a CSR, you will have access to a range of training and development programs, enabling you to enhance your skills and knowledge and advance your career. Work Environment and Company Culture arenaflex is a dynamic and supportive work environment, with a strong focus on teamwork, collaboration, and employee well-being. Our company culture is built on a foundation of respect, empathy, and compassion, with a commitment to making a positive impact on the lives of our members and providers. Compensation, Perks, and Benefits arenaflex offers a competitive compensation package, with a range of perks and benefits that recognize and reward your contributions to the organization. These may include health insurance, retirement plans, paid time off, and opportunities for career advancement and professional growth. Conclusion If you are a dedicated and empathetic customer service professional with a passion for healthcare and a commitment to excellence, we encourage you to apply for this exciting opportunity to join the arenaflex team. As a CSR, you will play a vital role in providing exceptional support to our members and providers, making a positive impact on their lives and contributing to the success of our organization. Apply now to take the first step in your career with arenaflex and discover a rewarding and challenging role that offers opportunities for growth, development, and advancement. Apply for this job