Customer Service Representative - Remote Quality Improvement and Care Management

Join the Mission to Revolutionize Healthcare Are you a motivated and customer-focused professional looking for a new challenge? Do you value care management and quality improvement? Are you excited about the opportunity to make a real difference in the lives of individuals across the country? If so, we invite you to join the Arsenault team as a Customer Service Representative in our remote quality improvement and care management division. About Us Arsenault is a rapidly growing national quality improvement and care management organization dedicated to ensuring that over 20 million people receive the right care, at the right time, in the right setting. We are a people-focused, mission-driven organization that values our employees and provides the training and support needed to excel in their careers. Our mission is to improve lives through healthcare quality and clinical expertise, and we believe that our employees are the key to achieving this goal. Our Culture and Values At Arsenault, we pride ourselves on our culture of care and compassion. We value our employees and strive to create a work environment that is supportive, inclusive, and rewarding. Our employees are our greatest asset, and we invest in their growth and development through comprehensive training programs, mentorship opportunities, and career advancement paths. We are committed to fostering a culture of diversity, equity, and inclusion, and we welcome applicants from all backgrounds. Our Commitment to Diversity and Inclusion Arsenault is an Equal Opportunity Employer, and we are committed to creating a workplace that is free from discrimination and harassment. We welcome applicants from all backgrounds and perspectives, and we are dedicated to providing a work environment that is inclusive and respectful of all employees. The Role As a Customer Service Representative, you will play a critical role in supporting the prior authorization process by answering incoming telephone calls, resolving customer questions, complaints, and requests while adhering to internal policies and procedures and utilizing working knowledge of the organization's services to meet productivity and quality standards. Key Responsibilities Develop and maintain working knowledge of internal policies, procedures, and services (both departmental and operational) Utilize automated systems to log and retrieve information and perform accurate and timely data entry of electronic faxes Receive inquiries from customers or providers by telephone, email, fax, or mail and communicate responses within required turnaround times Respond to telephone inquiries and complaints in a prompt, accurate, and courteous manner following standard operating procedures Interact with hospitals, physicians, beneficiaries, or other program recipients Investigate and resolve or report customer problems, identifying and escalating difficult situations to the appropriate party Meet or exceed standards for call volume and service level per department guidelines Initiate files by collecting and entering demographic, provider, and procedure information into the system Serve as liaison between the Review Supervisors and external providers Maintain logs and documents disposition of incoming and outgoing calls Requirements and Qualifications Essential Qualifications High school diploma or equivalent required Medical terminology course(s) helpful 2+ years of customer service/telephone experience in a similar call center environment and/or industry Knowledge, Skills, and Abilities Knowledge of: Medical terminology Health insurance industry Ability to: Speak English fluently enough to be clearly understood over the telephone Use phone system effectively Research and investigate Follow confidentiality policies and procedures Navigate and use electronic equipment and systems easily and proficiently Multitask on a personal computer while conducting telephone conversations Work in a fast-paced call center environment Remain calm and courteous when handling difficult calls and requests Skills: Bilingual Spanish-English a plus Effective verbal and listening skills to provide courteous and professional customer service Effective PC skills including electronic mail, intranet, and industry standard applications What We Offer Compensation and Benefits We offer a comprehensive compensation package that includes: Competitive salary Comprehensive health plans Paid time off Retirement savings Corporate wellness programs Educational assistance Corporate discounts and more Career Growth Opportunities At Arsenault, we are committed to the growth and development of our employees. We offer: Comprehensive training programs Mentorship opportunities Career advancement paths Ongoing feedback and coaching Work Environment As a remote Customer Service Representative, you will have the flexibility to work from home and enjoy: A comfortable and supportive work environment Flexibility to create your own schedule Opportunity to work with a talented and dedicated team Why Join Us? At Arsenault, we offer a unique opportunity to make a real difference in the lives of individuals across the country. Our mission-driven organization is dedicated to improving healthcare quality and clinical expertise, and we believe that our employees are the key to achieving this goal. By joining our team, you will have the opportunity to: Work with a talented and dedicated team Make a real difference in the lives of individuals across the country Grow and develop your skills and career Enjoy a comprehensive compensation package and benefits Work in a flexible and supportive remote environment How to Apply If you are a motivated and customer-focused professional looking for a new challenge, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and cover letter, to [insert contact information]. We look forward to hearing from you! Arsenault is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Apply for this job