Experienced Customer Service Representative for Medical Claims Processing and Resolution - arenaflex

Introduction to arenaflex and the Role arenaflex is a leading organization in the health benefits industry, dedicated to providing exceptional service and support to its members and providers. As a key player in the medical claims process, we are seeking an experienced and skilled Customer Service Representative to join our team. The successful candidate will be responsible for processing medical claims, communicating with providers, and resolving issues in a timely and professional manner. If you have a passion for delivering outstanding customer service and a keen interest in the healthcare industry, we encourage you to apply for this exciting opportunity. Job Summary The Customer Service Representative will serve as the primary liaison between arenaflex and its customers, providing expert guidance and support throughout the claims process. This role requires a strong technical understanding of health benefits programs, excellent communication skills, and the ability to work in a fast-paced environment. The ideal candidate will be a team player with a customer-centric approach, able to educate and inform members and providers about documentation requirements, payment information, and claim status. Key Responsibilities Act as the primary point of contact for customers, responding to inquiries and resolving issues related to the claims process and servicing processes. Educate and inform customers about documentation required to process a claim, required time frames, payment information, and claim status via multiple communication channels. Enter verbal and written application information accurately into the claims management system, meeting both internal and external customer requirements. Assign new claims to the appropriate claims handler and direct customer calls to the appropriate contact or escalate to a Service Center Specialist/management as needed. Maintain accurate and detailed claim notes on all calls, ensuring that all required details are documented in a concise and professional manner. Support the organization's quality program(s) and perform other duties as assigned. Essential Qualifications and Requirements To be considered for this role, candidates must have: Experience in claims and customer service, with a strong understanding of the healthcare industry and medical claims processing. Excellent communication and interpersonal skills, with the ability to educate and inform customers in a clear and concise manner. Strong technical skills, including proficiency in claims management systems and software applications. The ability to work in a fast-paced environment, prioritizing tasks and managing multiple responsibilities with ease. Strong problem-solving and analytical skills, with the ability to resolve issues and direct calls to the appropriate escalation path as needed. Must be a US Citizen and able to work a set shift, with options including 8:00am - 4:30pm, 8:30am - 5:00pm, and 11:30am - 8:00pm. Preferred Qualifications While not essential, the following qualifications are preferred: Previous experience working in a remote or virtual environment, with a strong ability to self-motivate and manage time effectively. Knowledge of health benefits programs and medical claims processing, with a strong understanding of industry regulations and guidelines. Experience working with claims management systems and software applications, with a strong technical skillset and ability to learn new systems quickly. Skills and Competencies To be successful in this role, candidates must possess the following skills and competencies: Communication skills: Excellent verbal and written communication skills, with the ability to educate and inform customers in a clear and concise manner. Technical skills: Strong technical skills, including proficiency in claims management systems and software applications. Problem-solving skills: Strong problem-solving and analytical skills, with the ability to resolve issues and direct calls to the appropriate escalation path as needed. Time management skills: The ability to work in a fast-paced environment, prioritizing tasks and managing multiple responsibilities with ease. Customer service skills: A customer-centric approach, with a strong focus on delivering exceptional service and support to members and providers. 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 opportunities, including: Comprehensive training programs, designed to enhance your knowledge and skills in medical claims processing and customer service. Ongoing coaching and feedback, to support your growth and development in the role. Opportunities for advancement, with a clear career path and opportunities for professional growth. Work Environment and Company Culture arenaflex is a dynamic and supportive work environment, with a strong focus on teamwork and collaboration. As a remote employee, you will be part of a virtual team, with regular communication and check-ins to ensure your success. Our company culture is built on the following values: Customer-centricity: A strong focus on delivering exceptional service and support to our members and providers. Integrity: A commitment to honesty, transparency, and ethics in all our interactions. Respect: A culture of respect, inclusivity, and diversity, with a strong focus on teamwork and collaboration. Compensation, Perks, and Benefits arenaflex offers a competitive compensation package, including a range of perks and benefits, such as: A comprehensive benefits package, including medical, vision, dental, 401K, and EAP services. A dynamic and supportive work environment, with a strong focus on teamwork and collaboration. Opportunities for advancement, with a clear career path and opportunities for professional growth. A flexible and remote work arrangement, with the ability to work from home and manage your own schedule. Conclusion If you are a motivated and customer-focused individual, with a passion for delivering exceptional service and support, we encourage you to apply for this exciting opportunity. As a Customer Service Representative at arenaflex, you will be part of a dynamic and supportive team, with a strong focus on teamwork and collaboration. With a range of training and development opportunities, a competitive compensation package, and a flexible and remote work arrangement, this is an opportunity not to be missed. Apply today to join our team and take the first step in your career with arenaflex! Apply for this job