Join arenaflex, a leading health care company, in making a meaningful impact on people's lives. As an Experienced Customer Service Representative, you will play a pivotal role in delivering exceptional customer experiences, working from the comfort of your own home. If you're passionate about helping others, have excellent communication skills, and are tech-savvy, we encourage you to apply for this exciting opportunity.
**About arenaflex**
arenaflex is a forward-thinking health care company dedicated to improving the health and vitality of those we serve. With a commitment to making health care more affordable, personalized, and focused on the whole person, we're driven to enhance the lives of our clients, customers, and patients. Our divisions, arenaflex Healthcare and arenaflex Health Services, work together to drive growth and improve lives.
**Job Summary**
As an Experienced Customer Service Representative, you will be part of a dedicated team that provides information regarding pharmacy benefits and drug coverage. You will interact with healthcare professionals, responding to phone inquiries with care, detail, and empathy. Your primary responsibilities will include:
* Collection of structured clinical data for prior authorization and non-formulary exception requests following the guidance provided in our online prior authorization tools and corresponding forms.
* Initial screening of requests based on guidance given by online prior authorization tools.
* Approves prior authorization requests if the data collected meets the approval specifications.
* Refers prior authorization requests that do not meet the approval specifications to a clinician for review.
* Independently responds to contacts ranging from routine to moderate complexity.
* May seek assistance with healthcare professionals for service issues of substantial complexity.
* Performs research to respond to inquiries and interprets policy provisions to determine the most effective response using established departmental procedures, HIPAA regulations, and corporate policies.
**Key Responsibilities**
* Respond to phone inquiries from healthcare professionals regarding pharmacy benefits and drug coverage.
* Collect and review structured clinical data for prior authorization and non-formulary exception requests.
* Approve or refer prior authorization requests based on the collected data and online prior authorization tools.
* Provide accurate and empathetic responses to inquiries, using excellent interpersonal and listening skills.
* Multitask and use computer-based resources effectively to manage multiple requests and tasks.
* Collaborate with healthcare professionals to resolve service issues of substantial complexity.
* Stay up-to-date with policy provisions, HIPAA regulations, and corporate policies to provide effective responses.
**Essential Qualifications**
* High School Diploma or equivalent.
* 1+ years of call center experience.
* Prior work-from-home experience.
* Prior medical or pharmacy knowledge.
* Reliable high-speed broadband internet, hard-wired connection (10 Mbps for download / 5 Mbps for upload).
* Quiet and private space designated for work without interruption.
**Preferred Qualifications**
* Excellent customer service skills.
* Excellent interpersonal communication, attention to detail, and critical thinking skills.
* Excellent computer skills, with familiarity of Microsoft Office and a working knowledge of Windows operating system.
* Tech-savvy, with the ability to easily navigate across multiple screens and applications.
* Ability to work any schedule between 8:00am – 9:00pm Eastern time, Monday through Friday.
* Permanent shifts will be chosen at the time of the job offer.
**Skills and Competencies**
* Excellent communication and interpersonal skills.
* Ability to multitask and manage multiple requests and tasks.
* Strong critical thinking and problem-solving skills.
* Ability to work independently and collaboratively as part of a team.
* Familiarity with Microsoft Office and Windows operating system.
* Tech-savvy, with the ability to easily navigate across multiple screens and applications.
**Career Growth Opportunities and Learning Benefits**
* arenaflex offers a comprehensive training program to ensure your success in this role.
* Opportunities for career growth and advancement within the company.
* Access to ongoing training and development programs to enhance your skills and knowledge.
* Collaborative and supportive work environment.
**Work Environment and Company Culture**
* arenaflex is a tobacco-free company and reserves the right not to hire tobacco/nicotine users in states where that is legally permissible.
* Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
* arenaflex has a commitment to diversity, equity, and inclusion, and we strive to create a work environment that is welcoming and inclusive for all employees.
**Compensation, Perks, and Benefits**
* Competitive salary and benefits package.
* Comprehensive training program.
* Opportunities for career growth and advancement.
* Collaborative and supportive work environment.
* Access to ongoing training and development programs.
* Flexible scheduling and work-from-home options.
**How to Apply**
If you're passionate about making a meaningful impact on people's lives and have the skills and qualifications we're looking for, 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.
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