Experienced Claims and Customer Care Specialist – Remote Opportunity at arenaflex

About arenaflex

At arenaflex, we're dedicated to delivering exceptional health insurance services to over 1.6 million Ohioans, empowering them to achieve their best possible health and quality of life. As a leading health insurance provider, we're committed to innovation, excellence, and customer satisfaction. Our team of passionate professionals is driven by a shared vision to make a meaningful difference in the lives of our members. If you're a customer-focused individual with a passion for claims processing and a drive to succeed, we invite you to join our dynamic team as a Claims and Customer Care Specialist.

Job Summary

We're seeking an experienced Claims and Customer Care Specialist to join our team in a remote work-from-home opportunity. As a key member of our team, you'll be responsible for processing routine to moderately complex claims while providing exceptional customer service through various communication channels. This role requires a unique blend of technical skills, customer service expertise, and a passion for delivering high-quality results. If you're a motivated and detail-oriented professional with a strong background in customer service and claims processing, we encourage you to apply for this exciting opportunity.

Responsibilities

As a Claims and Customer Care Specialist at arenaflex, you'll have the opportunity to make a meaningful impact on our members' lives. Your key responsibilities will include:

• Processing routine claims while providing customer service via inbound call queues, ensuring timely and accurate resolution of member inquiries.
• Handling inbound calls and written inquiries from members, providers, clients, employers, and brokers, providing empathetic and knowledgeable support.
• Conducting claims or inquiry-related research under the direction of senior staff, utilizing your analytical skills to resolve complex issues.
• Assisting with projects as directed by management, demonstrating your ability to adapt to changing priorities and deadlines.
• Mentoring and training junior team members in claims processing and customer service, sharing your expertise and experience to help them grow and develop.
• Conducting complex claims research projects in response to inquiries and escalations, utilizing your technical skills and knowledge to deliver accurate and timely results.
• Providing troubleshooting support for claims issues, working collaboratively with internal stakeholders to resolve complex problems.

Requirements

To be successful in this role, you'll need to possess the following qualifications and skills:

• Associate degree in business, healthcare administration, communications, or a related field, or an equivalent combination of training and experience.
• 1-5 years of customer service and/or claims experience, preferably in a call center in the health or dental insurance industry.
• Basic to advanced Microsoft Office skills, depending on the level of the position.
• Knowledge of dental benefits, services, terminology, and American Dental Association coding.
• Understanding of standard customer service best practices and principles.
• Knowledge of the Health Insurance Portability and Accountability Act (HIPAA).

Nice-to-Haves

While not required, the following certifications are highly desirable:

• Certified Dental Billing Specialist (CDBS)
• Certified Dental Coder (CDC)
• Certified Dental Assistant (CDA)

Benefits

As a valued member of our team, you'll enjoy a comprehensive benefits package, including:

• Employee bonus program
• 401(k) with company match up to 4% and additional company contribution
• Health Savings Account with company matching contribution
• Excellent medical, dental, vision, life, and disability insurance
• Access to an Employee Assistance Program for counseling and coaching
• Company holidays and up to 16 PTO days in the first year, with options to carry over unused PTO
• Parental leave for eligible employees after 120 days of service
• Career development programs and classes
• Tuition reimbursement up to $5,250 per year

Work Environment and Company Culture

As a remote employee, you'll have the flexibility to work from home while still being part of a dynamic and supportive team. Our company culture is built on a foundation of innovation, collaboration, and customer satisfaction. We're committed to creating a work environment that's inclusive, diverse, and respectful, where every employee feels valued and empowered to succeed.

How to Apply

If you're a motivated and customer-focused professional with a passion for claims processing, we invite you to apply for this exciting opportunity. Please submit your resume and a cover letter outlining your experience and qualifications. We can't wait to hear from you! Apply Now! Apply for this job