Experienced Customer Service Representative - National Remote

At arenaflex, we're dedicated to helping people live healthier lives and making the health system work better for everyone. As a Customer Service Representative, you'll play a critical role in delivering exceptional customer experiences to our members, ensuring they receive the care and support they need. If you're passionate about helping others and have a knack for problem-solving, we want to hear from you.

About arenaflex

arenaflex is a leading healthcare company that's committed to making a positive impact on people's lives. With a focus on innovation, quality, and accessibility, we're constantly pushing the boundaries of what's possible in healthcare. Our team is made up of talented individuals who share our passion for delivering exceptional care and service to our members.

Job Summary

As a Customer Service Representative, you'll be the first point of contact for our members, providing them with timely, accurate, and compassionate support. You'll work closely with our members to resolve issues, answer questions, and provide guidance on their health benefits. Your expertise, combined with our training and support, will enable you to deliver exceptional customer experiences and make a real difference in people's lives.

Key Responsibilities

* Answer incoming phone calls from customers and identify the type of assistance they need (e.g., benefit and eligibility, billing and payments, authorizations for treatment, and explanation of benefits)

• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
• Own problems through to resolution on behalf of the customer in real-time or through comprehensive and timely follow-up
• Review and research incoming healthcare claims from members and providers by navigating multiple computer systems and platforms and verifying the data/information necessary for processing
• 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 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
• 1+ years of customer service experience in an office or professional setting
• Ability to successfully complete the Customer Service training classes and demonstrate proficiency of the material
• This position will receive provider calls up to 50-70 calls daily and requires full attention to work duties. Employees in this role must be able to ensure they will have uninterrupted work time while they are on shift (outside of normally scheduled breaks and lunch)
• Ability to work any of our 8-hour shift schedules during our normal business hours of 7:00 am - 8:00 pm CST from Monday - Friday

Preferred Qualifications

* 1+ years of experience in customer service call center within the healthcare insurance industry

• Familiarity with medical and/or dental terminology, claims processing/coding, plan documents, or benefit plan design
• Experience with utilizing multiple systems/platforms while on a call with a member
• Experience with working with medical claims processing
• Presently employed within UHC Operations and Experience (also known as UHC Benefit Operations)

Soft Skills

* Ability to use computer and Windows PC applications, which includes strong keyboard and navigation skills and learning new computer programs

• 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)
• 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 overtime as needed

Work Environment and Culture

As a remote employee, you'll have the flexibility to work from anywhere within the U.S. while still being part of a dynamic and supportive team. Our culture is built on a foundation of compassion, empathy, and respect for our members and each other. We're committed to creating a work environment that's inclusive, diverse, and rewarding.

Compensation and Benefits

The hourly range for this role is $16.88 to $33.22 per hour based on full-time employment. Pay is based on several factors, including local labor markets, education, work experience, certifications, and more. In addition to your salary, you'll enjoy a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401(k) contribution (all benefits are subject to eligibility requirements).

How to Apply

If you're passionate about delivering exceptional customer experiences and making a real difference in people's lives, we want to hear from you. Apply now to join our team as a Customer Service Representative and take the first step towards a rewarding and challenging career with arenaflex.

Equal Employment Opportunity

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.

Drug-Free Workplace

arenaflex is a drug-free workplace, and candidates are required to pass a drug test before beginning employment. Apply for this job