Experienced Reimbursement Specialist and Customer Service Representative for Healthcare Benefits Verification and Management

Introduction to arenaflex arenaflex is a leading organization in the healthcare industry, dedicated to providing exceptional services that ensure seamless patient care and reimbursement processes. As a reputable and innovative company, arenaflex is committed to hiring talented professionals who share its vision of delivering outstanding customer experiences and making a positive impact in the lives of patients and healthcare providers. If you are a motivated and compassionate individual with a passion for healthcare and customer service, we invite you to join our team as a Reimbursement Specialist and Customer Service Representative. Job Overview In this critical role, you will be responsible for verifying patient insurance benefits, ensuring that healthcare providers have up-to-date information about patient insurance coverage, and guaranteeing that they receive appropriate reimbursement for their services. As a Reimbursement Specialist and Customer Service Representative, you will play a vital part in ensuring that patients receive uninterrupted treatment and that healthcare providers are reimbursed accurately and efficiently. This is a contract, project-based position that offers a unique opportunity to work with a dynamic team and gain valuable experience in the healthcare industry. Key Responsibilities Place outbound calls to verify patient insurance benefits and coverage changes, with a target of 35+ calls per day and 20 cases or more closed per day Contact insurance providers to verify information and confirm coverage details Collect and review patient insurance benefit information according to program standard operating procedures (SOPs) Complete and submit insurance forms and prior authorizations in a timely and accurate manner, ensuring adherence to third-party payer requirements Provide exceptional customer service to internal and external customers, resolving requests promptly and escalating complaints as needed Maintain regular phone contact with provider representatives, third-party customer service reps, and pharmacy staff Effectively communicate with payors for benefit investigations and coordinate with inter-departmental associates as necessary Process insurance and patient correspondence, reporting reimbursement trends or delays to the supervisor Provide all necessary documentation for prior authorizations, including demographic details and relevant identification numbers Analyze moderate scope problems within defined SOPs, exercising judgment to determine appropriate actions Report all adverse events in line with training and SOP, performing related duties as assigned with minimal instruction Requirements and Qualifications To be successful in this role, you must have: At least 1 year of experience in specialty pharmacy, medical insurance, healthcare setting, and/or related experience Patient and able to handle hold times of up to 90 minutes by client requirements A private, designated workspace that is free from distractions and interruptions Proficiency in MS Office, including Excel, Outlook, and Word Flexibility in schedule and hours, with the ability to work Monday to Friday, between 8:00 AM to 8:00 PM EST (40 hours) High school diploma or equivalent Employment verification required for the last 3 employers Background check required Preferred Qualifications While not required, the following qualifications are preferred: 2+ years of experience specific to healthcare benefits verification, which may qualify for a higher hourly rate Experience working in a call center or customer service environment Knowledge of healthcare insurance policies and procedures Excellent communication and problem-solving skills Ability to work in a fast-paced environment and meet productivity targets Skills and Competencies To excel in this role, you must possess the following skills and competencies: Excellent customer service skills, with the ability to provide empathetic and professional support to patients and healthcare providers Strong communication and interpersonal skills, with the ability to effectively communicate with internal and external stakeholders Ability to work in a team environment and collaborate with colleagues to achieve common goals Strong problem-solving and analytical skills, with the ability to analyze complex problems and develop effective solutions Ability to work in a fast-paced environment and meet productivity targets, with a focus on quality and accuracy Strong attention to detail and ability to maintain accurate records and documentation Career Growth and Learning Opportunities At arenaflex, we are committed to providing our employees with opportunities for growth and development. As a Reimbursement Specialist and Customer Service Representative, you will have access to: Comprehensive training programs, including approximately 3 weeks of training and ongoing support and coaching Opportunities for professional development and advancement within the company A dynamic and supportive work environment that encourages collaboration and innovation Recognition and reward programs that acknowledge and reward outstanding performance and contributions Work Environment and Company Culture arenaflex is a company that values its employees and is committed to creating a positive and supportive work environment. As a Reimbursement Specialist and Customer Service Representative, you will be working in a fully remote environment, with the flexibility to work from the comfort of your own home. You will also have access to a range of benefits and perks, including: Competitive hourly rate, with opportunities for overtime and bonuses Comprehensive benefits package, including health, dental, and vision insurance 401(k) retirement plan and matching program Paid time off and holidays, including tentative days off on December 24-25 and December 31-January 1 Opportunities for professional development and advancement within the company How to Apply If you are a motivated and compassionate individual who is passionate about healthcare and customer service, we encourage you to apply for this exciting opportunity. To apply, please follow these steps: Attend a position information session with our recruitment team Sign a "Right to Represent" agreement to work with our recruitment partner Complete a position requirements checklist and action items Participate in a Spark Hire one-way video interview Successfully complete all new hire requirements, including training and onboarding Pick up equipment in Lake Mary, FL, and complete mandatory online pre-assignment links, including HIPAA training Conclusion arenaflex is a dynamic and innovative company that is committed to delivering exceptional services and making a positive impact in the lives of patients and healthcare providers. As a Reimbursement Specialist and Customer Service Representative, you will play a vital role in ensuring that patients receive uninterrupted treatment and that healthcare providers are reimbursed accurately and efficiently. If you are a motivated and compassionate individual who is passionate about healthcare and customer service, we encourage you to apply for this exciting opportunity. Join our team and be part of a company that values its employees and is committed to creating a positive and supportive work environment. Apply for this job