Experienced Customer Service Representative – Remote Full-Time Opportunity with Competitive Hourly Rate at arenaflex

Introduction to arenaflex At arenaflex, we are driven by a singular, clear purpose: to bring our heart to every moment of our customers' healthcare journeys. This purpose guides our commitment to delivering enhanced, human-driven healthcare for a rapidly changing world. Embedded in our brand — with heart at its center — our mission sends a personal message that how we deliver our services is just as important as what we deliver. We are dedicated to empowering each and every individual who works at arenaflex to feel enabled by the role they play in transforming our culture and accelerating our ability to grow and deliver solutions to make healthcare more personal, convenient, and affordable. Job Overview We are seeking an experienced Customer Service Representative to join our team at arenaflex. As the face of our company, you will have the opportunity to make a meaningful impact on our customers' experiences by handling their requests and issues via phone, web, or written correspondence. Your role will be to engage, consult, and educate our customers based on their unique needs, preferences, and understanding of our plans, tools, and resources to guide them along a path to better health. Key Responsibilities Respond to questions and resolve issues based on calls/letters from customers, providers, and plan sponsors. Escalate emergencies to appropriate staff and record and track contacts with customers, providers, and plan sponsors. Guide customers through their plan of benefits, arenaflex policies, and procedures, as well as knowledge of resources to comply with any regulatory requirements. Make a personal connection with our customers by understanding and engaging them to the fullest to support their best health. Take ownership to understand the customer's needs by building a trusting and caring relationship with them completely. Anticipate customer needs and provide them with relevant information to address unasked questions, such as additional plan details, benefit plan details, customer self-service tools, and more. Utilize customer support limit framework to make financial decisions to resolve customer issues. Explain customer limitations as per contract. Process claim referrals, new case handoffs, nurse reviews, complaints (customer/provider), and appeals (customer/provider) via targeted system. Educate providers on our self-service options and assist providers with credentialing and re-credentialing issues. Answer demands received from arenaflex's Regulation Record Place regarding litigation and claims, and handle broad document review demands. Aid in preparation of complaint pattern reports and assist with integrating claim data for customer reviews. Determine clinical needs, relevant coverage policies, and verify customer plan eligibility related to incoming communication and internal referrals. Handle incoming requests for authorizations and pre-approvals not handled by Clinical Case Management. Perform review of customer claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible. Perform financial data entry as needed. Utilize relevant system tools and resources to generate quality letters and spreadsheets in response to requests received. Essential Qualifications To be successful in this role, you will need: A Bachelor's degree. Customer service experience in a transaction-based environment, such as a call center or retail store, with a demonstrated ability to be empathetic and compassionate. Experience in a production environment. Ability to multitask to efficiently accomplish tasks. Understanding of medical terminology. Strong oral and written communication skills. Proficiency with Microsoft Word and Outlook. Ability to maintain accuracy and production standards. Excellent communication and interpersonal skills. Technical skills. Problem-solving abilities. Attention to detail and accuracy. Preferred Qualifications While not required, the following qualifications are preferred: Previous experience in a customer-facing role, with a focus on delivering exceptional customer service. Knowledge of healthcare plans, policies, and procedures. Experience working in a fast-paced, dynamic environment. Career Growth Opportunities and Learning Benefits At arenaflex, we are committed to the growth and development of our employees. As a Customer Service Representative, you will have access to a range of training and development opportunities to help you build your skills and advance your career. You will also be part of a dynamic and supportive team that is passionate about delivering exceptional customer service. Work Environment and Company Culture Our company culture is built on a foundation of heart, with a focus on empathy, compassion, and understanding. We believe in creating a work environment that is supportive, inclusive, and empowering, where every employee feels valued and enabled to do their best work. As a remote worker, you will be part of a virtual team that is connected by a shared purpose and a commitment to delivering exceptional customer service. Compensation, Perks, and Benefits We offer a competitive hourly rate of $30-$41 per hour, as well as a range of benefits, including: Medical, dental, and vision benefits. 401(k) retirement savings plan. Employee Stock Purchase Plan. Term life insurance. Short-term and long-term disability benefits. Wellness programs. Education assistance. Free development courses. CVS store discount programs. Paid time off (PTO) or vacation pay. Paid holidays throughout the calendar year. Conclusion If you are a motivated and customer-focused individual who is passionate about delivering exceptional service, we encourage you to apply for this exciting opportunity to join our team at arenaflex. As a Customer Service Representative, you will be part of a dynamic and supportive team that is dedicated to making a positive impact on the lives of our customers. Don't miss out on this chance to build a rewarding and challenging career with a company that truly cares about its employees and its customers. Apply for this job