Welcome to arenaflex
At arenaflex, we are dedicated to simplifying the healthcare experience, creating healthier communities, and removing barriers to quality care. Our mission is to help people live healthier lives and make the health system work better for everyone. We believe that everyone deserves the opportunity to live their healthiest life, and we are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes.
Join Our Team
We are seeking a highly motivated and compassionate Customer Service and Claims Representative to join our team. As a Customer Service and Claims Representative, you will play a critical role in creating a quality experience for our members and their families. You will be responsible for answering incoming phone calls, identifying the type of assistance the customer needs, and resolving issues in a timely and professional manner. If you have a passion for helping others and are looking for a challenging and rewarding career, we encourage you to apply.
Primary Responsibilities
- Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)
- Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
- Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
- Review and research incoming healthcare claims from members and providers (doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits)
- Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)
- Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding
- Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance
Required Qualifications
- High School Diploma / GED OR 10 years of equivalent work experience
- Must be 18 years of age or older
- 2 years of previous or current claims processing experience with a claims processing system
- 1 year of customer service experience in an office or professional setting
- Ability to complete on the job training for this role during their normally scheduled 8 hour shift Monday - Friday between the hours of 7 am-8 pm CST
- Ability to work any of our 8-hour shift schedules during our normal business hours of 7:00am - 7:00pm CST. It may be necessary, given the business need, to work occasional overtime
Preferred Qualifications
- Familiarity with medical terminology, health plan documents, or benefit plan design
- Prior experience utilizing multiple systems/platforms while on a call with a member
Telecommuting Requirements
- Ability to keep all company sensitive documents secure (if applicable)
- Required to have a dedicated work area established that is separated from other living areas and provides information privacy
- Must live in a location that can receive an arenaflex approved high-speed internet connection or leverage an existing high-speed internet service
Soft Skills
- Demonstrated ability in using computer and Windows PC applications, which includes strong keyboard and navigation skills and learning new computer programs
- Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in a respectful, timely manner, consistently meeting commitments)
- Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the member
- Flexibility to customize approach to meet all types of member communication styles and personalities
- Proficient problem-solving approach to quickly assess current state and formulate recommendations
- Proficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrate personal resilience
- Ability to multi-task as well as the ability to understand multiple products and multiple levels of benefits within each product
- Ability to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule and work over-time as needed
Career Growth Opportunities and Learning Benefits
At arenaflex, we are committed to helping our employees grow and develop in their careers. We offer a range of training and development programs, including on-the-job training, mentorship, and career advancement opportunities. Our employees are encouraged to take ownership of their careers and pursue opportunities that align with their interests and skills.
Work Environment and Company Culture
At arenaflex, we are dedicated to creating a positive and inclusive work environment that values diversity, equity, and inclusion. We believe that our employees are our greatest asset, and we are committed to providing a workplace that is supportive, collaborative, and respectful. Our company culture is built on a foundation of integrity, compassion, and excellence, and we are committed to making a positive impact on the lives of our members and the communities we serve.
Compensation, Perks, and Benefits
At arenaflex, we offer a competitive compensation package that includes a range of benefits, including medical, dental, and vision insurance, 401(k) matching, and paid time off. We also offer a range of perks, including flexible scheduling, remote work options, and professional development opportunities. Our employees are rewarded and recognized for their performance and contributions to the company, and we are committed to providing a total rewards package that is competitive and comprehensive.
Conclusion
If you are a motivated and compassionate individual who is looking for a challenging and rewarding career, we encourage you to apply for the Customer Service and Claims Representative position at arenaflex. This is a unique opportunity to join a team that is dedicated to making a positive impact on the lives of our members and the communities we serve. We look forward to receiving your application and discussing this opportunity further.
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