**Experienced Customer Service Representative – National Remote**

At arenaflex, we're simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us and start doing your life's best work.

• *About arenaflex**

arenaflex is a leading health care company that's dedicated to helping people live healthier lives and making the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life. Our mission is to help people live healthier lives and make the health system work better for everyone.

• *Job Summary**

We're seeking an experienced Customer Service Representative to join our team in a national remote role. As a Customer Service Representative, you'll play a critical role in creating a quality experience for our customers and members. You'll be responsible for answering incoming phone calls, identifying the type of assistance the customer needs, and resolving issues in real-time or through comprehensive and timely follow-up. You'll also review and research incoming healthcare claims, communicate and collaborate with members and providers, and meet performance goals established for the position.

• *Key Responsibilities**

• Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)
• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
• Own problem through to resolution on behalf of the customer in real-time or through comprehensive and timely follow-up with the member
• Review and research incoming healthcare claims from members and providers (doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits)
• Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)
• Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding
• Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction, and attendance

• *Essential Qualifications**

• High School Diploma / GED OR 10 years of equivalent work experience
• Must be 18 years of age or older
• 2 years of previous or current claims processing experience with arenaflex's claims processing system (arenaflex's third-party administrator (TPA) solution)
• 1 year of customer service experience in an office or professional setting
• Ability to complete on-the-job training for this role during their normally scheduled 8-hour shift Monday - Friday between the hours of 7 am-8 pm CST
• Ability to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 7:00pm CST. It may be necessary, given the business need, to work occasional overtime

• *Preferred Qualifications**

• Familiarity with medical terminology, health plan documents, or benefit plan design
• Prior experience utilizing multiple systems/platforms while on a call with a member

• *Soft Skills**

• Demonstrated ability in using computer and Windows PC applications, which includes strong keyboard and navigation skills and learning new computer programs
• Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in a respectful, timely manner, consistently meeting commitments)
• Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the member
• Flexibility to customize approach to meet all types of member communication styles and personalities
• Proficient problem-solving approach to quickly assess current state and formulate recommendations
• Proficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrate personal resilience
• Ability to multi-task as well as the ability to understand multiple products and multiple levels of benefits within each product
• Ability to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule and work over-time as needed

• *Telecommuting Requirements**

• Ability to keep all company sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy
• Must live in a location that can receive an arenaflex-approved high-speed internet connection or leverage an existing high-speed internet service

• *Compensation and Benefits**

• Hourly range for California / Colorado / Connecticut / Hawaii / Nevada / New York / New Jersey / Washington / Rhode Island residents is $16.54 - $32.55 per hour
• Pay is based on several factors including but not limited to education, work experience, certifications, etc
• In addition to your salary, arenaflex offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements)

• *Why Join arenaflex?**

• arenaflex is a leading health care company that's dedicated to helping people live healthier lives and making the health system work better for everyone
• We believe everyone-of every race, gender, sexuality, age, location, and income-deserves the opportunity to live their healthiest life
• Our mission is to help people live healthier lives and make the health system work better for everyone
• We're committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission
• Diversity creates a healthier atmosphere: arenaflex is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law

• *How to Apply**

If you're passionate about making a difference in the lives of others and want to join a team that's dedicated to helping people live healthier lives, apply today!