**Experienced Customer Service Representative – Remote Opportunity with arenaflex**

At arenaflex, we're dedicated to carrying our heart to every moment of your wellbeing. Our mission is to deliver human-driven healthcare that makes a meaningful impact in a rapidly changing world. Rooted in our brand image, with heart at its core, our purpose sends a powerful message that how we deliver our services is just as important as what we deliver. arenaflex's Heart At Work Behaviors support this mission. We empower every individual who works at arenaflex to feel enabled by the role they play in transforming our lives and accelerating our ability to develop and deliver solutions that make healthcare more personal, accessible, and affordable. **Position Overview** As a Customer Service Representative at arenaflex, you'll be the face of our organization, influencing individuals' service experience through the way you handle customer care requests and issues via phone, web, or written correspondence. You'll connect with, counsel, and educate individuals based on their unique needs, preferences, and understanding of arenaflex plans, tools, and resources to guide them along a path to better health. We're a 24/7 customer support inbound call activity, including weekends and holidays, with the ability to work any shift, including expedited weekend and holiday shifts, a requirement for this position. **Key Responsibilities** - Respond to inquiries and resolve issues based on calls/letters from individuals, suppliers, and plan sponsors. - Escalate emergencies to the appropriate staff. Record and track contacts with individuals, suppliers, and plan sponsors. - Guide the member through their individual plan of benefits, arenaflex strategy, and methods, as well as knowing about resources to comply with any regulatory rules. - Establish a personal connection with our members by listening and engaging with the member to support their best health. - Take responsibility to understand the member's needs by building a trusting and caring relationship with the member completely. - Anticipate client needs. Provide the client with relevant information to address unasked questions, such as additional plan details, benefit plan details, member self-service tools, etc. - Utilize customer service software to make financial decisions to resolve member issues. - Make sense of member limitations according to contract. - Process claim references, new case handoffs, nurse surveys, complaints (member/supplier), and requests (member/supplier) via target system. - Educate suppliers on our self-service options; Assist suppliers with credentialing and re-credentialing issues. - Answer demands received from arenaflex's Regulatory Record Place regarding litigation; claims Handles broad document audit requests. - Aid in the preparation of protest pattern reports. Assist with integrating claim information for client reviews. - Determine clinical needs, relevant coverage arrangements, and checks member plan eligibility related to incoming correspondence and internal references. - Handle incoming requests for claims and pre-approvals not handled by Clinical Case Management. - Perform review of member claim history to ensure accurate tracking of benefit maximums and coinsurance/deductible. - Perform review of member claim history to ensure precise tracking of benefit maximums and coinsurance/deductible. - Perform financial data support as needed. - Utilize relevant system tools and resources to create quality letters and calculation sheets in response to requests received. **Required Capabilities** - Customer service experience in a transactional environment, such as a call center or retail store, demonstrating ability to be empathetic and compassionate. Experience in a production environment. - Ability to perform multiple tasks to efficiently complete responsibilities. - Understanding of clinical terminology. - Capable oral and written communication skills. - Proficient with Microsoft Word and Outlook. - Ability to maintain accuracy and production standards. - Transferable skills. - Technical skills. - Critical thinking skills. - Empathy and accuracy. **Logical Abilities** This pay range addresses the base hourly rate or base yearly full-time compensation for all situations in the job grade within which this position falls. The actual base compensation offer will depend on various factors including experience, education, location, and other significant elements. **arenaflex Benefits** In addition to your compensation, enjoy the benefits of an organization that puts its heart into caring for our partners and our communities. arenaflex offers a full range of clinical, dental, and vision benefits. Eligible employees may participate in the organization's 401(k) retirement savings plan, and a Stock Purchase Plan is also available for eligible employees. arenaflex provides a fully paid term life insurance plan to eligible employees, and short-term and long-term disability benefits. arenaflex also offers various wellness programs, education assistance, free development courses, a CVS store and discount programs with participating partners. Regarding downtime, arenaflex employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time, and other time off are provided consistently with relevant state regulation and Company policies. **Join arenaflex Today!** If you're passionate about delivering exceptional customer service and making a meaningful impact in the lives of others, we encourage you to apply for this exciting opportunity to join the arenaflex team. Apply for this job