At arenaflex, we are committed to delivering exceptional customer experiences that meet the evolving needs of our members and providers. As a key member of our customer experience team, you will play a vital role in ensuring that our customers receive the highest level of service, support, and care. If you are passionate about delivering outstanding customer experiences and have a strong background in customer service, we encourage you to apply for this exciting opportunity.
**Job Summary**
As an Experienced Customer Experience Representative III, you will be responsible for providing exceptional customer support and service to our members and providers across multiple states and products. You will be the primary point of contact for our customers, handling a high volume of calls, chats, emails, and other communication channels. Your primary goal will be to resolve issues and address needs fairly and effectively, while demonstrating arenaflex values in your actions. You will also be responsible for identifying opportunities to improve our member and provider experiences, and for representing member and provider issues in areas involving member and provider impact and engagement.
**Key Responsibilities**
* Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products, including phone, chat, email, and off-phone work supporting our Medicaid, Medicare, and/or Marketplace business.
* Handle escalated calls on behalf of management and provide excellent customer service for all call center communication channels.
* Accurately document all member and provider communication and maintain a high level of professionalism and courtesy in verbal and written communications.
* Work regularly scheduled shifts within our hours of operation, including lunches and breaks, and be available to work overtime and/or weekends as needed.
* Demonstrate the ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations.
* Listen skillfully, collect relevant information, determine immediate requests, and identify the customer's needs.
* Achieve individual performance goals established for this position in the areas of call quality, attendance, and scheduled adherence.
* Engage and collaborate with other departments to ensure seamless communication and support.
* Demonstrate personal responsibility and accountability by taking ownership of the call/issue and following it through to resolution, on behalf of the customer, in real time or through timely follow-up with the customer.
* Support member needs for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other areas, including complex issues.
* Support provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing, and other areas, including complex issues.
* Proficient in three or more lines of business (for example, Medicare, Medicaid, Marketplace, MMP) for members services, provider services, and member retention.
* Respond to incoming calls from providers on a variety of issues of varying complexity, including highly complex or executive issues.
* Complete research for state, legislative, or regulatory inquiries as applicable.
* Gather information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions.
* Achieve individual performance goals as it relates to call center objectives.
* Proactively engage and collaborate with other departments as required.
* Demonstrate personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations.
* Assist with formal training needs of other employees along with new hire or training classes as needed.
* Support provider and member needs for a wide variety of inquiries involving member eligibility and covered benefits.
* Provide inquiry assistance involving claims, authorizations, appeals, contracting, credentialing, and other provider-related issues.
* Support other inquiry areas, including complex issues.
* Conduct initial research and work to immediately resolve issues.
* Appropriately escalate issues based on established risk criteria.
* Recommend and implement programs to support member needs.
* Resolve member inquiries and complaints fairly and effectively to ensure member retention.
* Respond to incoming calls from members and providers.
* Conduct member satisfaction assessment services and other member surveys as applicable and based on business needs.
* Assist other retention or inbound functions as dictated by service level requirements.
**Essential Qualifications**
* Associate's Degree or equivalent combination of education and experience.
* 3-5 years of customer service or sales experience in a fast-paced, high-volume environment.
* Proficient in multiple lines of business (for example, Medicare, Medicaid, Marketplace, MMP) for members services, provider services, and member retention.
* Strong communication and interpersonal skills, with the ability to build rapport with customers and colleagues.
* Ability to work in a team environment and collaborate with other departments.
* Strong problem-solving and critical thinking skills, with the ability to analyze complex issues and develop effective solutions.
* Ability to work in a fast-paced environment and meet productivity and quality standards.
* Strong organizational and time management skills, with the ability to prioritize tasks and manage multiple projects simultaneously.
**Preferred Qualifications**
* Bachelor's Degree or equivalent combination of education and experience.
* 5-7 years of customer service or sales experience in a fast-paced, high-volume environment.
* Broker/Healthcare insurance licensure.
* Proficient in multiple systems, including Microsoft Office, Genesys, Salesforce, Pega, QNXT, CRM, Verint, Kronos, Microsoft Teams, Video Conferencing, CVS Caremark, Availity, Molina Provider Portal, and others as required by line of business or state.
**Work Environment and Company Culture**
At arenaflex, we are committed to creating a work environment that is inclusive, diverse, and supportive. We believe that our employees are our greatest asset, and we strive to provide a workplace that is engaging, challenging, and rewarding. Our company culture is built on the principles of respect, empathy, and teamwork, and we encourage our employees to take ownership of their work and to contribute to the success of our organization.
**Career Growth Opportunities and Learning Benefits**
arenaflex is committed to the growth and development of our employees. We offer a range of training and development programs, including on-the-job training, classroom training, and online courses. We also provide opportunities for advancement and career growth, and we encourage our employees to take on new challenges and to pursue their career goals.
**Compensation, Perks, and Benefits**
arenaflex offers a competitive benefits and compensation package, including:
* Hourly pay rate: $13.41 - $29.06
* Opportunities for overtime and bonuses
* Comprehensive health insurance package
* 401(k) retirement plan with company match
* Paid time off and holidays
* Flexible work arrangements, including remote work options
* Professional development and training opportunities
* Recognition and rewards for outstanding performance
**How to Apply**
If you are passionate about delivering exceptional customer experiences and have a strong background in customer service, we encourage you to apply for this exciting opportunity. Please submit your application through our website, including your resume and a cover letter that outlines your qualifications and experience. We look forward to hearing from you!
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