Remote Healthcare Customer Service Representative - Member Support Specialist (National Telecommute Position)

Join arenaflex: Transform Healthcare Delivery One Call at a Time

Are you ready to make a meaningful impact in people's lives while building a rewarding career? At arenaflex, we're revolutionizing the healthcare experience by simplifying complex systems, 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 healthcare 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.

Even if you have no prior experience in the healthcare industry, we have comprehensive training classes starting soon to help you build the successful career you deserve. We provide the support, structure, and world-class training—you bring the interest, motivation, and passion for helping others. This is your opportunity to join a team dedicated to supporting our members and their families every single day.

About This Opportunity

As a Customer Service Representative at arenaflex, you'll join us on a mission to deliver not just the best customer service in the healthcare industry, but the best customer service—period. Your natural compassion and customer service expertise, combined with our robust support system, extensive training, and continuous development opportunities, will ensure your success in this role.

This is no small opportunity. This is where you can bring your genuine compassion for others while doing meaningful work that matters. In this role, you play a critical part in creating a quality experience for the members and providers we support by providing accurate, professional, personalized, and compassionate help, guidance, and support—focusing on first-call resolution in a high-volume, fast-paced environment.

Every interaction gives you the opportunity to improve the lives of our customers and exceed their expectations. You'll spend the majority of your day responding to calls from our members, answering questions, and resolving issues regarding healthcare eligibility, claims, and payments. You'll also dedicate time to reviewing, researching, and processing healthcare claims with the goal of ensuring every claim receives a fair and thorough review.

What You'll Do: Key Responsibilities

As a vital member of our customer service team, you'll be responsible for:

• Customer Call Management: Address and resolve customer service calls empathetically and professionally, ensuring every interaction leaves a positive impression.
• Documentation and Research: Accurately document, research, and resolve all inquiries, ensuring documentation is clear, complete, and meets our high-quality standards.
• First-Call Resolution: Respond and resolve inquiries on the first call by identifying the topic and type of assistance the caller needs—including benefits, eligibility, material requests, physician assignments, claims, billing, and payment—utilizing all available resources effectively.
• Follow-Up Management: Monitor and expeditiously close any inquiries requiring follow-up based on departmental guidelines, ensuring no member is left without answers.
• Escalation Protocol: Refer unresolved inquiries and grievances to designated areas for investigation, serving as an advocate for our members until their issues are resolved.
• Problem Ownership: Own problems through resolution on behalf of the caller in real-time or through comprehensive and timely follow-up with support resources. Partner with others to resolve complex issues completely.
• Provider Coordination: Intervene with care providers (doctor's offices) on behalf of participants, assisting with appointment scheduling, access to care issues, and other provider-related matters.
• Provider Support: Assist providers with all levels of requests, demonstrating strong problem-solving skills to achieve resolution.
• Cross-Functional Collaboration: Coordinate with field Care Team staff for issue elevation and resolution, ensuring seamless support across all departments.
• Compliance and Knowledge: Maintain up-to-date knowledge and understanding of claims policies, regulatory requirements, and guidelines to ensure accurate information delivery.
• Resource Utilization: Successfully utilize all available resources to handle inquiries and multitask effectively in a dynamic environment.
• Performance Excellence: Meet or exceed individual and departmental quality standards and achieve performance goals consistently.
• Policy Adherence: Adhere to, keep updated, and utilize all company guidelines, policies, and procedures in daily operations.
• Workload Management: Prioritize and adjust individual workload to ensure departmental goals are met without compromising quality.
• Additional Responsibilities: Assume responsibility for ad hoc projects or functions that promote the future success of the operation.

Schedule and Work Environment

This position is full-time (40 hours per week), Monday through Friday. Employees are required to have flexibility to work any of our 8-hour shift schedules during normal business hours of 8:00 AM to 8:00 PM EST. Given business needs, it may occasionally be necessary to work overtime.

All telecommuters will be required to adhere to arenaflex's Telecommuter Policy, which includes maintaining a dedicated work area separated from other living areas that provides information privacy. You must live in a location that can receive an approved high-speed internet connection or leverage an existing high-speed internet service to ensure reliable connectivity during work hours.

Training and Development

We offer weeks of paid on-the-job training, with duration based on the needs of the candidate. The hours during training will be any 8-hour shift between 8:00 AM and 8:00 PM CST from Monday through Friday. Training will be conducted virtually from your home, giving you the flexibility to learn in a comfortable environment while still receiving comprehensive support from our training team.

Throughout your career at arenaflex, you'll have access to continuous learning opportunities, mentorship programs, and professional development resources. You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role, as well as provide development pathways for other roles you may be interested in pursuing.

What We're Looking For: Required Qualifications

• High School Diploma / GED OR 10+ years of equivalent working experience


• Minimum 2+ years of Customer Service experience


• Ability to successfully complete the Customer Service training classes and demonstrate proficiency of the material


• Ability to type at a minimum speed of 40+ WPM (words per minute)


• Ability to work regularly scheduled shifts within the hours of operation 8:00 AM - 8:00 PM EST, including the flexibility to work occasional overtime based on business need


• Availability to work 2 evening shifts per week (typically 11:00 AM - 8:00 PM EST)


• Availability to work 3 holidays not observed by the client (Day after Thanksgiving, Christmas Eve, New Year's Day)


• Must be 18 years of age or older

Preferred Qualifications

While not required, the following qualifications will help you excel in this role:

• 1+ years of prior experience in an automatic call distribution (ACD) call center setting


• Knowledge of CPT / ICD-10 coding


• Familiarity with Medicare / Medicaid guidelines


• Previous experience in healthcare customer service or related fields

Essential Skills and Competencies

To thrive in this role, you'll need to demonstrate:

• Empathy and Compassion: A 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 and consistently meeting commitments.


• Active Listening: Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests, and identify the current and future needs of the member.


• Problem-Solving: A proficient problem-solving approach to quickly assess current state and formulate actionable recommendations.


• Communication: Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon.


• Adaptability: Flexibility to customize approach to meet all types of member communication styles and personalities.


• Resilience: Proficient conflict management skills, including the ability to resolve issues in a stressful situation and demonstrating personal resilience under pressure.


• Schedule Flexibility: Ability to work regularly scheduled shifts within our hours of operation, including the training period, with flexibility to adjust daily schedule and work overtime and/or weekends as needed.

Compensation and Benefits

We recognize that our team members are our greatest asset, and we're committed to providing competitive compensation and comprehensive benefits. For positions in California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington, or Rhode Island, the hourly range is $16.00 to $28.27 per hour. Pay is based on several factors, including but not limited to education, work experience, certifications, and relevant qualifications.

In addition to your salary, arenaflex offers a comprehensive benefits package that includes:

• Medical, dental, and vision coverage


• Life insurance and disability benefits


• 401(k) retirement plan with company matching


• Equity stock purchase programs


• Incentive and recognition programs


• Paid time off and wellness programs


• Employee assistance programs


• Tuition reimbursement and professional development opportunities

All benefits are subject to eligibility requirements. No matter where or when you begin a career with arenaflex, you'll find a far-reaching choice of benefits designed to support your health, wealth, and well-being.

Our Culture and Mission

At arenaflex, our mission is to help people live healthier lives and make 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. Today, however, there are still far too many barriers to good health, which are disproportionately experienced by people of color, historically marginalized groups, and those with lower incomes. We are 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.

arenaflex is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

Ready to Begin Your Journey?

If you're passionate about helping others, thrive in a fast-paced environment, and want to be part of a team that's transforming healthcare, we encourage you to apply today. This is more than just a job—it's an opportunity to grow your career, develop valuable skills, and make a real difference in the lives of millions of people.

Bring your compassion, your drive, and your desire to learn, and we'll provide everything else you need to succeed. Apply now and start doing your life's best work with arenaflex!