**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 dedicated to providing innovative solutions that improve the lives of our members and their families. We're committed to creating a healthier world, one person at a time. Our team of passionate professionals is driven by a shared vision of making a positive impact on the lives of others. We believe that everyone deserves access to quality health care, regardless of their background or circumstances. **Join Our Mission** As a Customer Service Representative at arenaflex, you'll play a critical role in creating a quality experience for our members and their families. You'll be the face of our company, providing exceptional customer service and support to those who need it most. We're looking for someone who is passionate about helping others, has excellent communication skills, and is able to work in a fast-paced environment. **Key Responsibilities** * Answer incoming phone calls from customers and identify the type of assistance they need (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 problems 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 **Training and Development** We provide comprehensive training and development programs to ensure your success in this role. Our training classes are designed to help you build the skills and knowledge you need to excel in this position. You'll have the opportunity to learn from experienced professionals and gain hands-on experience in a supportive and collaborative environment. **Requirements** * 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 **Compensation and Benefits** We offer a competitive compensation package, including a comprehensive benefits program, incentive and recognition programs, equity stock purchase, and 401(k) contribution. Our benefits package is designed to support your physical, emotional, and financial well-being. **Work Environment and Culture** We're committed to creating a work environment that's inclusive, supportive, and empowering. Our team is passionate about making a positive impact on the lives of others, and we're looking for someone who shares our values and is committed to excellence. **Diversity, Equity, and Inclusion** 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 are committed to excellence, we encourage you to apply for this exciting opportunity. Please submit your application through our website or by clicking the link below. Apply Job! **Note:** arenaflex is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to creating a work environment that is inclusive, supportive, and empowering. Apply for this job