Experienced Customer Service Advocate – National Remote Healthcare Support Role

At arenaflex, we're dedicated to delivering exceptional customer experiences that exceed our members' expectations. As a Customer Service Advocate, you'll play a vital role in providing timely, accurate, and empathetic support to our members, ensuring they receive the care and benefits they need. If you're passionate about delivering outstanding service, navigating complex healthcare systems, and making a meaningful impact, we invite you to join our team.

About arenaflex

arenaflex is a leading provider of innovative healthcare solutions, committed to empowering individuals and families to achieve better health outcomes. Our team of dedicated professionals shares a common goal: to make a positive difference in the lives of our members. With a strong focus on customer-centricity, we strive to create a supportive and inclusive environment that fosters growth, learning, and collaboration.

Responsibilities

As a Customer Service Advocate, you'll be responsible for:

• Answering incoming phone calls from customers and identifying the type of assistance they need, including benefit and eligibility, billing and payments, authorizations for treatment, and explanation of benefits (EOBs)
• Asking appropriate questions and listening actively to identify specific questions or issues while documenting required information in computer systems
• Owning problems through to resolution on behalf of the customer in real-time or through comprehensive and timely follow-up with the member
• Reviewing and researching incoming healthcare claims from members and providers by navigating multiple computer systems and platforms and verifying the data/information necessary for processing (e.g., pricing, prior authorizations, applicable benefits)
• Ensuring that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g., claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)
• Communicating and collaborating with members and providers to resolve issues, using clear, simple language to ensure understanding
• Meeting performance goals established for the position in the areas of efficiency, accuracy, quality, member satisfaction, and attendance

Key Performance Indicators (KPIs)

* First Call Resolution (FCR) rate

• Average Handling Time (AHT)
• Member Satisfaction (MSAT) scores
• Quality Monitoring (QM) scores
• Attendance and punctuality

Requirements

* High School Diploma / GED or equivalent work experience

• Must be 18 years of age or older
• 2+ years of customer service experience
• Ability to work full-time, Monday - Friday between 7:00am - 6:00pm CST, including the flexibility to work occasional overtime given the business need

Nice-to-Haves

* Healthcare/Insurance environment (familiarity with medical terminology, health plan documents, or benefit plan design)

• Social work, behavioral health, disease prevention, health promotion, and behavior change (working with vulnerable populations)
• Sales or account management experience
• Bilingual fluency in English and Spanish

Benefits

* Comprehensive benefits package, including medical, dental, and vision coverage

• Incentive and recognition programs to reward your hard work and dedication
• Equity stock purchase opportunities to help you grow your wealth
• 401(k) contribution to support your long-term financial goals

Career Growth Opportunities and Learning Benefits

At arenaflex, we're committed to helping you grow and develop your skills and expertise. As a Customer Service Advocate, you'll have access to:

• Ongoing training and development programs to enhance your knowledge and skills
• Mentorship and coaching from experienced colleagues
• Opportunities for career advancement and professional growth
• A supportive and inclusive work environment that fosters collaboration and teamwork

Work Environment and Company Culture

Our remote work environment is designed to promote flexibility, productivity, and work-life balance. As a Customer Service Advocate, you'll have the opportunity to work from the comfort of your own home, with access to:

• A state-of-the-art virtual workspace with all the tools and resources you need to succeed
• Regular virtual team meetings and check-ins to stay connected with your colleagues
• A comprehensive onboarding program to ensure a smooth transition to our team

How to Apply

If you're passionate about delivering exceptional customer experiences and making a meaningful impact in the lives of our members, we invite you to apply for this exciting opportunity. Please submit your resume and a cover letter outlining your experience, skills, and qualifications. We can't wait to hear from you! Apply to this job Apply for this job