Experienced Medical Customer Service Representative – Healthcare Coverage and Claims Support

Are you passionate about delivering exceptional customer service and making a positive impact on people's lives? Do you have a strong background in medical terminology and a knack for problem-solving? If so, we encourage you to apply for the Experienced Medical Customer Service Representative role at arenaflex, a leading healthcare organization dedicated to providing outstanding coverage and compassionate support to our members.

About arenaflex

arenaflex is a company of real people committed to quality and building a better future for healthcare. Founded in Oregon in 1955, we've been serving our community for over 60 years, offering comprehensive benefits to our employees and connecting with neighbors to create healthy spaces and places. We value diversity and inclusion in our workplace, and we invite applications from candidates who share our commitment to this diversity.

Job Summary

As an Experienced Medical Customer Service Representative at arenaflex, you will be responsible for providing phone customer service to members of multiple benefit plans, analyzing caller's needs, and providing timely and accurate responses. You will answer calls from policyholders, members, agents, providers, hospitals, pharmacists, and others regarding a variety of issues and questions related to a member's health plan. This is a full-time work-from-home position that requires excellent communication skills, analytical abilities, and a passion for delivering exceptional customer service.

Key Responsibilities

* Answer 50+ calls a day regarding claims and benefit questions from callers on both group and individual plans

• Provide solutions to problems, confirm eligibility, verify premiums, and collect payments for members on individual plans
• Explain benefits and/or plan coverage to members
• Apply mathematical skills to determine correct benefit information and premium amounts for Individual plans
• Exercise judgment, initiative, and discretion in confidential and sensitive matters
• Perform related duties, including:

+ Reviewing, updating, and becoming familiar with new and revised benefit information or claim processing procedures + Reviewing and explaining any authorization requirements of the plan using online tools available + Updating and entering primary care physician selections if required by member's plan + Gathering banking details so monthly premium for members on Individual plans can be collected + Requesting claim adjustments required because of error in processing or any new information that has been received + Resolving and recording complaints, appeals, and inquiries + Completing provider searches using available online web-based systems to assist members in finding providers that meet their needs and that of the plan + Contacting physicians, dentists, hospitals, and other providers when necessary to answer questions and obtain or provide information + Providing timely follow-up and return calls when required + Documenting all aspects of a call in a clear and concise manner + Answering calls within service level time + Other duties and projects as assigned by Manager/Supervisor/Lead

Requirements

* High school diploma or equivalent

• Practical knowledge of medical terminology desired
• Knowledge of diagnosis and procedure coding desired
• Claim processing experience or prior customer service experience or other related experience such as medical/dental office experience
• Excellent oral and written communication skills
• Ability to interact professionally, patiently, and courteously with customers over the phone
• Good analytical, problem-solving, and decision-making skills
• 10-key proficiency of 105 spm net on a computer numeric keypad
• Type a minimum of 25 wpm net on a computer keyboard
• High-speed internet (cable or fiber)
• Proficiency with Microsoft Office applications, with the ability to open and navigate multiple windows at the same time
• Ability to achieve and maintain quality and quantity standards
• Ability to work well under pressure in a complex and rapidly changing environment
• Ability to be at work on time and daily
• Maintain confidentiality and project a professional business presence
• Ability to repeatedly analyze situations and communicate effectively in a fast-paced environment that includes dealing with angry people
• Ability to organize and remain up-to-date on changing and new information

Essential Skills and Competencies

* Strong communication and interpersonal skills

• Ability to work in a fast-paced environment with multiple priorities
• Analytical and problem-solving skills
• Ability to maintain confidentiality and handle sensitive information
• Proficiency with Microsoft Office applications
• Ability to work independently and as part of a team
• Strong customer service skills
• Ability to adapt to changing situations and priorities

Career Growth Opportunities and Learning Benefits

arenaflex is committed to providing opportunities for growth and development to our employees. As an Experienced Medical Customer Service Representative, you will have the opportunity to:

• Develop your skills and knowledge in medical terminology, claim processing, and customer service
• Work with a diverse team of professionals who share your passion for delivering exceptional customer service
• Participate in ongoing training and development programs to enhance your skills and knowledge
• Take on additional responsibilities and projects to challenge yourself and grow in your role
• Enjoy a comprehensive benefits package, including medical, dental, vision, pharmacy, life, and disability insurance, as well as 401K matching and FSA

Work Environment and Company Culture

arenaflex is a dynamic and fast-paced organization that values diversity, inclusion, and teamwork. As an Experienced Medical Customer Service Representative, you will work in a remote environment, with the flexibility to work from home and manage your own schedule. You will be part of a team of professionals who share your passion for delivering exceptional customer service and making a positive impact on people's lives.

Compensation, Perks, and Benefits

arenaflex offers a competitive compensation package, including:

• $18.03 - $20.18 hourly, depending on experience
• Comprehensive benefits package, including medical, dental, vision, pharmacy, life, and disability insurance
• 401K matching and FSA
• Employee Assistance Program
• PTO and company-paid holidays
• Opportunities for growth and development

How to Apply

If you are passionate about delivering exceptional customer service and making a positive impact on people's lives, we encourage you to apply for the Experienced Medical Customer Service Representative role at arenaflex. Please submit your application, including your resume and cover letter, to [insert contact information]. We look forward to hearing from you!

Equal Employment Opportunity

arenaflex is an equal employment opportunity employer and welcomes applications from candidates who share our commitment to diversity and inclusion. We are committed to providing equal opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status, or any other status protected by law. Apply for this job