**Job Summary:**
Join arenaflex, a leading healthcare company dedicated to delivering enhanced human-centric healthcare, as an Experienced Customer Service Representative. In this remote work-from-home role, you will be responsible for managing customer queries, processing orders, and escalating complaints across various communication channels. If you possess excellent customer service skills, a calm demeanor, and experience working with computers, we encourage you to apply.
**About arenaflex:**
arenaflex is a healthcare company that shares a single, clear purpose: Bringing our heart to every moment of your health. Our purpose guides our commitment to deliver enhanced human-centric healthcare for a rapidly changing world. Anchored in our brand – with heart at its center – our purpose sends a personal message that how we deliver our services is just as important as what we deliver.
Our Heart At Work Behaviors support this purpose. We want everyone who works at arenaflex to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make healthcare more personal, convenient, and affordable.
**Responsibilities:**
As an Experienced Customer Service Representative at arenaflex, you will be responsible for:
* Maintaining a positive, empathetic, and professional attitude toward customers at all times
* Responding promptly to customer inquiries
* Communicating with customers through various channels
* Acknowledging and resolving customer complaints
* Knowing our products inside and out so that you can answer questions
* Processing orders, forms, applications, and requests
* Keeping records of customer interactions, transactions, comments, and complaints
* Communicating and coordinating with colleagues as necessary
* Providing feedback on the efficiency of the customer service process
* Managing a team of junior customer service representatives
**Key Responsibilities:**
* Answer questions and resolve issues based on phone calls/letters from members, providers, and plan sponsors
* Triage resulting rework to appropriate staff
* Provide excellent customer services for high-volume inbound provider calls for the Claims Inquiry/Claims Research team
* Extensive claims research on multiple platforms to assist providers with payment questions
* Provide the customer with related information to answer unasked questions, e.g., additional plan details, benefit plan details, member self-service tools, etc.
* Use customer service threshold framework to make financial decisions to resolve member issues
* Explain member's rights and responsibilities in accordance with contract
* Process claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance, and appeals (member/provider) via target system
* Educate & assist providers on our self-service options
* Assist providers with credentialing and re-credentialing and contracting questions and issues
* Assist in compiling claim data for customer audits
* Determine medical necessity, applicable coverage provisions, and verify member plan eligibility relating to incoming correspondence and internal referrals
**Required Qualifications:**
* MUST live in the state of Oklahoma full-time
* Familiarity with Microsoft Office products
* Experience in highly transactional call center environment
* Excellent customer service and critical thinking
* High-speed internet access (25 mbps or higher) and consistent connection
* Work location must be set up with a direct connection to the router (NOT Wi-Fi)
* We provide a 6 ½ foot long ethernet cord, if the distance is further, you will be required to provide your own ethernet cable
**Education:**
* High School diploma or GED equivalent
**Work Environment:**
* This is a remote work-from-home opportunity
* Must be able to attend 4 weeks of training (virtual) between the hours of 8-5 CST
* After training, the permanent schedule is Monday-Friday and can start as early as 7 am CST and end as late as 7 pm CST
**Career Growth Opportunities:**
* arenaflex offers a range of career growth opportunities, including promotions, training, and development programs
* Our company culture is focused on empowering employees to take ownership of their careers and make a meaningful impact on our business
**Learning Benefits:**
* arenaflex offers a range of learning benefits, including training programs, mentorship opportunities, and access to industry-leading resources
* Our company culture is focused on continuous learning and development, and we encourage our employees to pursue their passions and interests
**Work Environment and Company Culture:**
* arenaflex is a dynamic and fast-paced work environment that is passionate about delivering exceptional customer service
* Our company culture is focused on empowering employees to take ownership of their careers and make a meaningful impact on our business
* We value diversity, equity, and inclusion, and strive to create a workplace that is welcoming and inclusive for all employees
**Compensation, Perks, and Benefits:**
* arenaflex offers a competitive compensation package, including salary, benefits, and perks
* Our company culture is focused on recognizing and rewarding employee contributions, and we offer a range of recognition and reward programs to recognize employee achievements
**How to Apply:**
If you are a motivated and customer-focused individual who is passionate about delivering exceptional customer service, we encourage you to apply for this exciting opportunity. Please visit our website to learn more about arenaflex and our company culture, and to submit your application.
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