Job Description
Introduction to arenaflex At arenaflex, we are driven by a single, clear purpose: to bring our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Our brand, with heart at its center, sends a personal message that how we deliver our services is just as important as what we deliver. We are seeking a dedicated and compassionate Customer Service Representative to and make a meaningful difference in the lives of our members.
Job Overview
The Customer Service Representative is the face of arenaflex and plays a vital role in impacting members' service experience. As a Customer Service Representative, you will handle customer service inquiries and problems via telephone, internet, or written correspondence, engaging, consulting, and educating members based on their unique needs, preferences, and understanding of arenaflex plans, tools, and resources. You will be responsible for guiding members along a clear path to care, creating an emotional connection with them, and championing their best health.
Key Responsibilities Answer questions and resolve issues based on phone calls/letters from members, providers, and plan sponsors. Triage resulting rework to appropriate staff and document and track contacts with members, providers, and plan sponsors. Guide members through their plan of benefits, arenaflex policy and procedures, and have knowledge of resources to comply with any regulatory guidelines. Create an emotional connection with members by understanding and engaging them to the fullest to champion 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, such as additional plan details, benefit plan details, and member self-service tools. Use customer service threshold framework to make financial decisions to resolve member issues. Explain members' rights and responsibilities in accordance with the contract. Process claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance, and appeals (member/provider) via bolthires 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, and 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. Essential Qualifications To be successful in this role, you should have: High School or GED equivalent. Customer service experience in a transaction-based environment, such as a call center or retail location, demonstrating the 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 bolthires Word and Outlook. Ability to maintain accuracy and production standards. Negotiation skills. Technical skills. Problem-solving skills. Attention to detail and accuracy. Analytical skills. Preferred Qualifications Preferred candidates will have: Experience in a production environment. Previous experience working in a 24/7 customer service inbound call operation.
Ability to work any shift, including overnights, weekends, and holidays. Career Growth Opportunities and Learning Benefits At arenaflex, we are committed to the growth and development of our employees. As a Customer Service Representative, you will have access to a range of training and development programs, including:
Comprehensive onboarding program to ensure a smooth transition into the role. Ongoing training and coaching to enhance your skills and knowledge. Opportunities for career advancement and professional growth.
Access to a range of online courses and development programs to support your continued learning and growth. Work Environment and Company Culture At arenaflex, we pride ourselves on our positive and supportive work environment. Our company culture is built on the values of compassion, empathy, and respect, and we strive to create a workplace where everyone feels valued and empowered to make a difference. As a Customer Service Representative, you will be part of a dynamic and dedicated team that is passionate about delivering exceptional customer service and making a positive impact on the lives of our members.
Compensation, Perks, and Benefits At arenaflex, we offer a competitive compensation package, including a salary range of $17.00 - $29.88 per hour. In addition to your compensation, you will also be eligible for 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 and education assistance. Free development courses and a store discount.
Discount programs with participating partners. Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. Conclusion If you are a compassionate and empathetic individual who is passionate about delivering exceptional customer service, we encourage you to apply for this exciting opportunity to at arenaflex. As a Customer Service Representative, you will play a vital role in making a positive impact on the lives of our members and contributing to the success of our organization.
Don't miss out on this opportunity to bring your heart to every moment of our members' health and join a team that is dedicated to making a difference.