Experienced Customer Service Representative - Work From Home Opportunity at arenaflex

At arenaflex, we're passionate about delivering exceptional customer experiences that exceed our customers' expectations. As a Customer Service Representative, you'll play a vital role in helping us achieve this goal. We're urgently hiring for this role, and we're looking for talented individuals who share our commitment to providing world-class service.

About arenaflex

arenaflex is a leading healthcare company that's dedicated to transforming the way healthcare is delivered. Our purpose is to bring our heart to every moment of our customers' health, and we're committed to making healthcare more personal, convenient, and affordable. We're a company that values innovation, collaboration, and customer-centricity, and we're looking for like-minded individuals to join our team.

Our Heart At Work Behaviors

At arenaflex, we believe that our Heart At Work Behaviors are essential to delivering exceptional customer experiences. These behaviors include:

• Customer Focus: We're committed to putting our customers at the heart of everything we do.
• Collaboration: We believe that teamwork is essential to achieving our goals and delivering exceptional service.
• Innovation: We're always looking for new and better ways to deliver service and improve our customers' experiences.
• Accountability: We take ownership of our actions and are accountable for delivering exceptional service.
• Respect: We treat our customers, colleagues, and partners with respect and dignity.

Job Summary

As a Customer Service Representative, you'll be responsible for providing exceptional customer service to our customers via phone, email, and other channels. You'll be the first point of contact for our customers, and you'll play a critical role in resolving their issues and answering their questions. You'll also be responsible for processing claims, educating providers on our self-service options, and assisting with credentialing and re-credentialing.

Key Responsibilities

* Answer questions and resolve issues based on phone calls/letters from members, providers, and plan sponsors.

• Triages resulting rework to appropriate staff.
• Provide excellent customer service for high-volume inbound provider calls for the Claims Inquiry/Claims Research team.
• Extensive claims research on multiple platforms to assist providers with payment questions.
• Provides the customer with related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc.
• Uses customer service threshold framework to make financial decisions to resolve member issues.
• Explains member's rights and responsibilities in accordance with contract.
• Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system.
• Educates & assists providers on our self-service options.
• Assists providers with credentialing and re-credentialing and contracting questions and issues.
• Assists in compiling claim data for customer audits.
• Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals.

Required Qualifications

* MUST live in the state of Florida full-time.

• Familiarity with Microsoft Office products.
• Experience in highly transactional call center environment.
• Excellent customer service and critical thinking.
• High-speed internet access (25 mbps or higher) and consistent connection.
• Work location must be set up with a direct connection to the router (NOT Wi-Fi). We provide a 6 ½ foot long ethernet cord, if the distance is further, you will be required to provide your own ethernet cable.

Education

* High School diploma or GED equivalent.

Work Schedule

* This position is work from home and you must live in the State of Florida.

• Must be able to attend 4 weeks of training (virtual) between the hours of 8-5 EST.
• After training, the permanent schedule is an Monday-Friday and can start as early as 8 am EST and end as late as 7 pm EST.

Compensation and Benefits

* The typical pay range for this role is: $17.00 - $25.15.

• This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
• In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. The Company offers a full range of medical, dental, and vision benefits. Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees. The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long-term disability benefits. arenaflex also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners. As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year.

How to Apply

If this role sounds like a perfect fit, don't hesitate. Apply today and let's build the future together. Apply To This Job Apply for this job