Job Description
At arenaflex, we're committed to providing exceptional healthcare solutions to our nation's military, veterans, Guard, and Reserves, as well as their families. As a leading not-for-profit health insurer and federal government contractor, we're seeking a talented and dedicated Customer Service Representative to join our team. If you're passionate about delivering top-notch customer service, navigating complex medical and insurance terminology, and working in a fast-paced call center environment, we encourage you to apply for this exciting opportunity. **About arenaflex** arenaflex is a health solutions company that has been making healthcare easier for the people we serve for nearly 80 years. As a proud military and veteran-ready organization, we're committed to serving our nation's heroes and their families. Our culture is built on creating an open and empowering employee experience, where our people can bring their authentic selves to work every day. We're proud of the recognition we've received from local and national organizations for our culture and workplace, and we're excited to welcome talented individuals like you to our team. **Job Summary** As a Customer Service Representative, you'll play a critical role in providing call center telephone support, as well as responses to written inquiries submitted by military members, retirees, and dependents eligible for both TRICARE and Medicare benefits. You'll be responsible for assisting with claims and billing inquiries from hospitals and clinics, navigating multiple systems to research and resolve complex inquiries with a clear, accurate, and easy-to-understand response. This is a Bargaining Unit/Union position, and you'll have the opportunity to work in a fun, supportive team environment that offers great advancement opportunities throughout the organization. **Key Responsibilities** * Receive telephone, written, fax, and e-mail inquiries concerning TRICARE eligibility, benefits determinations, and claims adjudication questions or billing problems * Apply appropriate provisions of TRICARE regulations, interpretations, and procedural directives in making determinations on eligibility and benefits to determine appropriate responses to inquiries * Obtain and analyze claims data to determine specific problem areas, including external communication to obtain data * Complete research and provide final resolution to inquiries within contractual requirements * Communicate with inquirers to determine appropriate authorization or referral of services * Submit claims for adjudication, correction, payment, or review as appropriate * Educate providers on billing requirements of TRICARE to reduce claim problems * Deal tactfully with people in a wide variety of situations to convey a favorable corporate image * Respond to inquirers using various forms of communication (written letter, telephone, web, or email) within time frames to exceed contractual standards * Collect and record data for Customer Service records and computer analysis * Inform supervisory staff of system problems when identified, researching problems to provide backup data and examples when needed **Essential Qualifications** * U.S. citizenship is required for this position due to Department of Defense restrictions * Must live within the vicinity of our Madison, WI campus location (45 miles from 1717 W. Broadway, Madison, WI) * High school diploma or equivalent * 2 or more years of experience in customer service (call center) * Ability to learn medical and insurance terminology * Strong listening skills and ability to provide timely, accurate answers via telephone **Preferred Qualifications** * Expertise in Microsoft Office (Outlook, Word, Excel), internet, intranet, office equipment, and data entry * Ability to navigate dual monitor screens and between multiple programs at once * Strong skillsets in multi-tasking, research, and problem-solving * Ability to work independently, deescalate situations with agitated individuals, control difficult situations, as well as influence and motivate others to comply with TRICARE procedures **Remote Work Requirements** * Wired (ethernet cable) internet connection from your router to your computer * High-speed cable or fiber internet with a minimum of 10 Mbps downstream and at least 1 Mbps upstream internet connection (can be checked at **Benefits** * Bargaining Unit position * Remote and hybrid work options available * Performance bonus and/or merit increase opportunities * 401(k) with dollar-per-dollar match up to 6% of salary (100% vested immediately) * Competitive paid time off * Health insurance, dental insurance, and telehealth services start DAY 1 * Professional and Leadership Development Programs **What You'll Gain from This Role** * Gaining experience working in a call center environment * Having the ability to work remotely from home * Building in-depth communication and customer service skills * Being a part of a fun, supportive team that offers great advancement opportunities throughout the organization * Working in an environment that serves our Nation's military, veterans, Guard, and Reserves, as well as their families **How to Apply** If you're a motivated and customer-focused individual who is passionate about delivering exceptional service, we encourage you to apply for this exciting opportunity. Please submit your application through our website, and we'll be in touch to discuss your qualifications further. **Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities** arenaflex is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to creating an inclusive and empowering employee experience, where our people can bring their authentic selves to work every day. Apply for this job