At arenaflex, we're revolutionizing the healthcare industry by providing innovative solutions that put patients at the forefront. As a Customer Service Representative, you'll play a vital role in delivering exceptional support to our health plan members and providers, ensuring they receive accurate, timely, and meaningful information. If you're passionate about making a difference in people's lives and possess excellent communication skills, we encourage you to join our team.
**About arenaflex**
arenaflex is a leading healthcare company dedicated to transforming the way healthcare services are delivered. Our mission is to provide personalized, patient-centered care that empowers individuals to take control of their health. We're committed to fostering a culture of innovation, collaboration, and excellence, and we're seeking talented individuals like you to join our team.
**Job Summary**
As a Customer Service Representative, you'll be responsible for providing top-notch support to our health plan members and providers, resolving issues, and building strong relationships. You'll work in a remote call center environment, utilizing your excellent communication skills, attention to detail, and problem-solving abilities to deliver exceptional results. If you're a motivated and customer-focused individual with a passion for healthcare, we invite you to apply for this exciting opportunity.
**Key Responsibilities**
* Answer phone calls and emails from health plan members and providers, resolving issues and providing accurate information in a timely and professional manner.
* Assist providers with member benefit information, eligibility, referrals/authorization, and claim processing information with 100% accuracy.
* Direct calls and emails to the correct department and escalate as needed, ensuring seamless communication and resolution.
* Build and maintain strong relationships with providers and members, handling questions, concerns, and resolving issues/complaints with speed and professionalism.
* Document provider and member complaints, determine the appropriate course of action, and follow up to ensure the complaint is resolved.
* Provide provider and member outreach calls for resolutions and follow-ups.
* Process voicemail returns and document all interactions and transactions with the caller in the appropriate areas.
* Interact and build relationships with Member Support, Medical Management, Pharmacy, Eligibility, and other departments as needed.
* Provide provider and member portal support, ensuring seamless access to information and services.
* Work in accordance with US regulatory and Quality System requirements (21 CFR 820, etc.).
* Perform other duties as assigned by management.
**Qualifications**
To succeed in this role, you'll need:
* 6-12 months of related experience and/or training in a call center environment in healthcare, insurance plan areas, including knowledge of basic claim processing.
* Excellent attendance is critical to success in this position.
* Internal candidates must have been in their current role for at least 6 months and have no performance or attendance actions in effect.
* Excellent computer and phone skills, attention to detail, process and policy adherence.
* Excellent verbal and written communication skills.
* Strong interpersonal skills.
* Active listening skills to accurately respond to inquiries and requests.
* Exceptional organizational skills, retention of policy and process a must.
* Intermediate skills minimum in Google and Microsoft Office suite of products a must.
* Bilingual in English and Spanish preferred but not required.
**Education and Experience**
* High school diploma or general education degree (GED); or one to three months related experience and/or training; or equivalent combination of education and experience.
* Administrative/Healthcare experience a plus but not required.
**Work Shifts and Environment**
* Monday – Friday, 8am – 5:00pm CST.
* Remote position, requiring a quiet, secure, and private workspace with no distractions.
* Must have password-protected, stable internet access – a stipend will be provided.
* Office equipment will be supplied, including a PC, monitor, keyboard, mouse, and headset.
* While performing the duties of this Job, the employee is regularly required to sit; use hands to handle or feel; talk; and hear.
* The employee is frequently required to reach with hands and arms.
* Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
* For this position, the percentage of expected Travel is: 0% of the time.
**Training Expectations**
* You'll attend a 3-week minimum remote training program, with mandatory attendance for the full training period.
* Training will be Monday through Friday, 8:30am – 5pm CST.
* You'll be required to take daily competency exams and a retention exam on the Friday of both weeks of training, with passing grades of 90% or above.
* We also request, with the exception of emergencies, that you do not request any time off within the first 120 days of employment.
**Why Join arenaflex?**
* Competitive compensation and benefits package.
* Opportunities for career growth and professional development.
* Collaborative and dynamic work environment.
* Recognition and rewards for outstanding performance.
* Comprehensive training and support to ensure your success.
**How to Apply**
If you're a motivated and customer-focused individual with a passion for healthcare, we invite you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, through our website. We look forward to hearing from you!