Experienced Bilingual Customer Service Representative (English + Spanish) – Healthcare Industry

At arenaflex, we're dedicated to delivering exceptional customer experiences that exceed our members' expectations. As a Bilingual Customer Service Representative, you'll play a vital role in shaping the way we interact with our members, providers, and plan sponsors. If you're passionate about delivering top-notch service, have a flair for languages, and are eager to join a dynamic team, we want to hear from you!

About arenaflex

arenaflex is a leading healthcare organization that's committed to transforming the way we deliver care. Our purpose is to bring our heart to every moment of our members' health, and we're anchored in our brand with heart at its center. We believe that how we deliver our services is just as important as what we deliver, and that's why we're dedicated to creating a culture that's centered around empathy, compassion, and understanding.

Our Heart At Work Behaviors

Our Heart At Work Behaviors support our purpose and guide our commitment to delivering exceptional customer experiences. We want everyone who works at arenaflex to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions that make healthcare more personal, convenient, and affordable.

Position Summary

As a Bilingual Customer Service Representative, you'll be the face of arenaflex, impacting members' service experiences by handling customer inquiries and problems via telephone, internet, or written correspondence. You'll engage, consult, and educate members based on their unique needs, preferences, and understanding of arenaflex plans, tools, and resources to help guide them along a clear path to care.

Key Responsibilities

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

• Triage resulting rework to appropriate staff
• Document and track contacts with members, providers, and plan sponsors
• Guide members through their plan of benefits, arenaflex policy, and procedures, as well as having knowledge of resources to comply with regulatory guidelines
• Create an emotional connection with members by understanding and engaging them to the fullest to champion for their best health
• Take accountability to fully understand members' needs by building a trusting and caring relationship with them
• Anticipate customer needs and provide related information to answer unasked questions
• Use customer service threshold framework to make financial decisions to resolve member issues
• Explain members' rights and responsibilities in accordance with contract
• Process claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance, and appeals (member/provider) via target system
• Educate providers on self-service options and assist with credentialing and re-credentialing issues
• Respond to requests received from arenaflex's Law Document Center regarding litigation and lawsuits
• Handle extensive file review requests
• Assist in preparation of complaint trend reports and compile claim data for customer audits
• Determine medical necessity, applicable coverage provisions, and verify member plan eligibility relating to incoming correspondence and internal referrals
• Handle incoming requests for appeals and pre-authorizations not handled by Clinical Claim Management
• Perform review of member claim history to ensure accurate tracking of benefit maximums and/or coinsurance/deductible
• Perform financial data maintenance as necessary
• Use applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received

Required Qualifications

* Bilingual – written and oral fluency in Spanish + English

• High School or GED equivalent

Preferred Qualifications

* Customer Service experience in a transaction-based environment such as a call center or retail location, demonstrating ability to be empathetic and compassionate

• Ability to multi-task to accomplish workload efficiently
• Understanding of medical terminology
• Proficient oral and written communication skills
• Proficient with Microsoft Word and Outlook
• Ability to maintain accuracy and production standards
• Negotiation skills
• Technical skills
• Problem-solving skills
• Attention to detail and accuracy
• Analytical skills

Work Environment and Company Culture

As a Bilingual Customer Service Representative, you'll be working in a dynamic, fast-paced environment that's centered around delivering exceptional customer experiences. You'll be part of a team that's passionate about making a difference in the lives of our members, and you'll have the opportunity to grow and develop your skills in a supportive and inclusive culture.

Compensation, Perks, and Benefits

arenaflex offers a competitive salary range of $17.00 - $29.88, depending on experience, education, and other relevant factors. In addition to your compensation, you'll enjoy a range of benefits, including:

• Medical, dental, and vision benefits
• 401(k) retirement savings plan
• Employee Stock Purchase Plan
• Fully-paid term life insurance plan
• Short-term and long-term disability benefits
• Well-being programs
• Education assistance
• Free development courses
• CVS store discount
• Discount programs with participating partners
• Paid Time Off (PTO) or vacation pay
• Paid holidays throughout the calendar year

Career Growth Opportunities and Learning Benefits

At arenaflex, we're committed to helping our employees grow and develop their skills. As a Bilingual Customer Service Representative, you'll have the opportunity to:

• Develop your customer service skills and expertise
• Learn about our products and services
• Participate in training and development programs
• Collaborate with cross-functional teams to drive business results
• Take on new challenges and responsibilities as you grow and develop in your role

How to Apply

If you're passionate about delivering exceptional customer experiences and have a flair for languages, we want to hear from you! Apply now to join our dynamic team and be part of a culture that's centered around empathy, compassion, and understanding. Apply To This Job

We Encourage You to Apply!

Even if you feel you're not a perfect match, we'd still love to hear from you. We're looking for great people to join our friendly team, and we're excited to learn more about your skills and experience. Don't hesitate to apply – we can't wait to hear from you! Apply for this job