Healthcare Customer Service Specialist II (SCA) - Remote Opportunity at arenaflex

Join arenaflex, a leading independent healthcare payment integrity company in the US, and be part of a dynamic team that's revolutionizing the way healthcare providers interact with the Medicare system. Are you passionate about delivering exceptional customer service and have a strong background in healthcare and customer service? Do you thrive in a fast-paced environment and enjoy working with diverse stakeholders? If so, we invite you to apply for the Healthcare Customer Service Specialist II (SCA) role at arenaflex.

About arenaflex

At arenaflex, we're dedicated to helping our clients achieve their goals by providing innovative payment accuracy solutions that allow them to focus on what matters most – quality of care and healthier lives for all. Our mission is to offer cutting-edge payment integrity solutions that empower our clients to make informed decisions and improve patient outcomes.

About the Opportunity

As a Healthcare Customer Service Specialist II (SCA) at arenaflex, you'll play a critical role in providing professional, accurate, and timely responses to CMS (Medicare) and provider inquiries. This is a fully remote opportunity, and we're looking for candidates who are self-motivated, organized, and able to work independently.

Key Responsibilities:

* Maintain a current knowledge of all contract requirements and objectives

• Develop professional working relationships with colleagues, healthcare providers, and other Medicare contractors
• Take inbound calls from providers to answer questions and resolve complex issues
• Make outbound calls to healthcare providers as a courtesy to confirm if letters requesting records for review have been received
• Respond to assigned written communications from providers timely and accurately
• Educate providers on proper process protocols and their appeal rights
• Establish appropriate contacts and perform necessary research to validate provider contact information
• Conduct critical due diligence follow-ups if additional research or action is required to resolve an inquiry
• Enter and update all contact and activity information into tracking logs and the audit platform where not automatically completed by the system
• Research and route internal/external communications to the appropriate person or department
• Notify management of:

+ All escalated displeasure with the audit program + Legal action + Government intervention + Escalated concerns regarding audit issues and edit parameters + Suggestions to improve or correct processes or documents

• Perform miscellaneous duties as assigned in a highly professional manner

Knowledge, Skills, and Abilities Needed:

* Excellent verbal and written communication skills

• Skilled in data entry and knowledge of computers
• Working knowledge of Excel
• Courteous, professional, and respectful attitude
• Strong understanding of customer service policies and processes
• Ability to learn CMS rules and regulations and understand the CMS Recovery Audit Contractor program
• Healthcare and insurance terminology knowledge preferred but not required
• Flexibility to prioritize and handle non-standard situations that may arise
• Must be detailed, organized, and able to manage various job duties as required
• Maintain a strong work ethic and attendance

Required and Preferred Qualifications:

* At least two years' experience in a call center or customer service position required

• At least one year claims processing/billing experience preferred
• High School diploma or GED is required
• Must maintain HIPAA Certification

What We Offer:

At arenaflex, we're committed to providing a comprehensive benefits package that supports a healthy work-life balance. Our benefits include:

• Medical, dental, vision, disability coverage options
• Life insurance coverage
• 401(k) savings plans
• Paid family/parental leave
• 11 paid holidays per year
• Sick time and vacation time off annually
• Flexible work arrangements, including remote work options

Physical Requirements & Additional Notices:

If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee's responsibility to maintain this Internet access at their home office location.

Equal Opportunity Employer:

arenaflex is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.

How to Apply:

If you're passionate about delivering exceptional customer service and have a strong background in healthcare and customer service, we invite you to apply for the Healthcare Customer Service Specialist II (SCA) role at arenaflex. Please submit your application through our website or by contacting our Talent Acquisition team directly.

Note:

arenaflex is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position:

• Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions)
• Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions
• Some positions may require the total absence of felony and/or misdemeanor convictions
• Must not appear on any state/federal debarment or exclusion lists
• Must complete the arenaflex Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures
• Other requirements may apply

Confidentiality and Integrity of Data:

All employees and contractors for arenaflex may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to arenaflex's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination. Apply for this job