Experienced Customer Service Representative – Remote Medicare Appeal Support and Resolution Specialist

Welcome to arenaflex: Empowering Better Health Outcomes

arenaflex exists to empower better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact. We are a team of passionate individuals dedicated to being a vital partner for health solutions in the public sector. At arenaflex, we believe in leading the way and embracing our company's mission, actively engaging in problem-solving, and taking ownership of our work daily.

Job Summary

We are seeking an experienced Customer Service Representative to join our growing team. As a Customer Service Representative at arenaflex, you will be responsible for supporting the Medicare Appeal process by answering incoming telephone calls, resolving customer questions, complaints, and requests, adhering to internal policies and procedures, and utilizing your working knowledge of our services to meet productivity and quality standards. This position is remote, offering you the flexibility to work from the comfort of your own home.

Key Responsibilities

• Develop and maintain a working knowledge of internal policies, procedures, and services (both departmental and operational)
• Utilize automated systems to log and retrieve information, and perform accurate and timely data entry of electronic faxes
• Receive inquiries from customers or providers by telephone, email, fax, or mail, and communicate responses within required turnaround times
• Respond to telephone inquiries and complaints in a prompt, accurate, and courteous manner, following standard operating procedures
• Interact with hospitals, physicians, beneficiaries, or other program recipients, and investigate and resolve or report customer problems
• Identify and escalate difficult situations to the appropriate party, and meet or exceed standards for call volume and service level per department guidelines
• Initiate files by collecting and entering demographic, provider, and procedure information into the system, and serve as a liaison between the Review Supervisors and external providers
• Maintain logs and documents disposition of incoming and outgoing calls

Essential Qualifications

• High School diploma or equivalent
• 2+ years of customer service/telephone experience in a similar call center environment and/or industry
• Ability to effectively communicate with team members and external customers
• Ability to research and resolve issues related to Medicaid program and service eligibility
• Bilingual (Spanish/English)

Preferred Qualifications/Experience

• Previous experience in the medical office or other medical setting preferred
• General knowledge of eligibility verification (Medicaid eligibility and program requirements for specific program of focus preferred)
• Knowledge of CPT and HCPCS codes preferred
• PC proficiency to include Microsoft Office Suite
• Experience with Microsoft programs

Skills and Competencies

To be successful in this role, you will need to possess excellent communication and problem-solving skills, with the ability to work in a fast-paced environment. You should be highly organized, with a strong attention to detail and the ability to multitask. Additionally, you should be proficient in using automated systems and have experience with data entry.

Career Growth Opportunities and Learning Benefits

At arenaflex, we are committed to the growth and development of our employees. We offer a range of training and development programs, designed to help you build your skills and advance your career. You will have the opportunity to work with a talented team of professionals, who are passionate about delivering exceptional customer service and improving health outcomes.

Work Environment and Company Culture

arenaflex is a dynamic and supportive work environment, where you will be valued and respected as a member of our team. We believe in fostering a culture of innovation, collaboration, and continuous improvement, and we are committed to making a positive impact on the lives of our customers and the communities we serve.

Compensation, Perks, and Benefits

We offer a competitive compensation package, with a pay range of $15.85 - $18.20 per hour, depending on experience and qualifications. Our benefits package includes comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts, and more. We also offer a range of perks, including flexible working hours, remote work options, and opportunities for professional development and growth.

Conclusion

If you are a motivated and customer-focused individual, with a passion for delivering exceptional service and improving health outcomes, we encourage you to apply for this exciting opportunity. At arenaflex, we are committed to making a positive impact on the lives of our customers and the communities we serve, and we believe that you can play a vital role in helping us achieve our mission. Don't miss out on this opportunity to join our team and take your career to the next level. Apply now and become a part of the arenaflex team!

We are an Equal Opportunity Employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable Federal, State, or Local law.

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