Customer Service Representative - Member Support & Healthcare Benefits Assistance (24/7 Call Center)

Join the arenaflex Team: Transforming Customer Care in Healthcare

Are you passionate about making a meaningful difference in people's lives? Do you thrive in fast-paced environments where every interaction matters? Welcome to arenaflex – where heart meets healthcare, and every moment is an opportunity to transform someone's day.

At arenaflex, we believe that healthcare should be personal, convenient, and affordable. Our commitment to delivering human-centric health solutions for a rapidly evolving world sets us apart in the industry. We are seeking talented individuals who share our vision and are ready to embark on a rewarding career journey as a Customer Service Representative.

When you join arenaflex, you become part of a legacy of compassion and excellence. Our team members are the face of our organization, and their dedication to service is what makes us who we are. We don't just answer calls – we build relationships, solve complex problems, and most importantly, we care for our members as if they were family.

Position Overview

As a Customer Service Representative at arenaflex, you will be the frontline ambassador for our members' healthcare experience. This role is far more than a traditional call center position – it is a chance to be a health advocate, a problem solver, and a trusted advisor for members navigating their healthcare benefits.

We operate a 24/7 customer service inbound call operation that serves our members around the clock, 365 days a year. This includes weekends and holidays. We are looking for candidates who can be flexible and work any shift based on business needs, including overnights, weekends, and holidays. This commitment to around-the-clock availability ensures that our members always have access to the support they need, when they need it most.

Key Responsibilities

As a valued member of the arenaflex customer service team, you will:

• Address member inquiries with excellence: Answer questions and resolve issues received through phone calls, letters, and written correspondence from members, healthcare providers, and plan sponsors. Your ability to listen actively and respond with empathy will be crucial in creating meaningful connections.
• Navigate complex benefit landscapes: Guide members through their unique plans of benefits, arenaflex policies and procedures, and provide knowledge of resources to comply with regulatory guidelines. You will serve as a trusted resource, helping members understand their coverage and maximize their benefits.
• Create emotional connections: Engage, consult, and educate members based upon their unique needs, preferences, and understanding of arenaflex plans, tools, and resources. Your role is to champion for our members' best health at every interaction.
• Build trusting relationships: Take accountability to fully understand each member's needs by building a trusting and caring relationship. Listen intently, show genuine compassion, and follow through on commitments made during every interaction.
• Anticipate customer needs: Go beyond answering the asked questions by providing the customer with related information to answer unasked questions. This includes sharing additional plan details, benefit plan information, and member self-service tools that can enhance their experience.
• Make financial decisions: Use our customer service threshold framework to make financial decisions that resolve member issues effectively and appropriately.
• Ensure compliance: Explain member's rights and responsibilities in accordance with their contract and all applicable regulations.
• Process various requests: Handle claim referrals, new claim handoffs, nurse reviews, complaints from members and providers, grievances, and appeals through our target system with precision and attention to detail.
• Support healthcare providers: Educate providers on self-service options and assist them with credentialing and re-credentialing issues to ensure smooth operations.
• Handle documentation: Respond to requests received from arenaflex's Law Document Center regarding litigation and lawsuits, and handle extensive file review requests with confidentiality and accuracy.
• Contribute to quality improvement: Assist in preparing complaint trend reports and compiling claim data for customer audits to help improve our overall service quality.
• Verify coverage and eligibility: Determine medical necessity, applicable coverage provisions, and verify member plan eligibility relating to incoming correspondence and internal referrals.
• Manage appeals and authorizations: Handle incoming requests for appeals and pre-authorizations that are not handled by Clinical Claim Management.
• Review claim history: Perform comprehensive reviews of member claim history to ensure accurate tracking of benefit maximums, coinsurance, and deductibles.
• Maintain financial accuracy: Perform financial data maintenance as necessary to ensure all records remain current and accurate.
• Create documentation: Use applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received, maintaining professionalism and clarity in all communications.
• Triage and document: Appropriately route resulting rework to appropriate staff. Document and track all contacts with members, providers, and plan sponsors systematically.

Essential Qualifications

To succeed in this role, you will need:

• High School diploma or GED equivalent
• Strong commitment to customer service excellence
• Excellent oral and written communication skills
• Ability to work flexible shifts, including overnights, weekends, and holidays
• Proficiency with Microsoft Word and Outlook
• Ability to maintain accuracy and production standards in a fast-paced environment
• Strong attention to detail and accuracy
• Ability to multitask and accomplish workload efficiently
• Problem-solving skills and analytical thinking

Preferred Qualifications

We prefer candidates with additional experience and skills, including:

• Customer service experience in a transaction-based environment such as a call center or retail location
• Demonstrated ability to be empathetic and compassionate in customer interactions
• Experience working in a production-oriented environment
• Understanding of medical terminology
• Negotiation skills to handle complex customer situations
• Technical proficiency to navigate multiple systems and tools
• Strong analytical skills to interpret benefits information and resolve issues

What We Offer

At arenaflex, we believe in rewarding our team members for their dedication and hard work. We offer a comprehensive benefits package that includes:

• Competitive Compensation: The typical pay range for this role is $17.00 - $29.88 per hour, depending on experience, education, and location. Your actual base salary offer will depend on various factors including your relevant background and qualifications.
• Health Benefits: Full range of medical, dental, and vision benefits for you and your family
• Retirement Savings: Eligible employees may enroll in our 401(k) retirement savings plan with company matching
• Stock Purchase Plan: Employee Stock Purchase Plan available for eligible employees
• Life Insurance: Fully-paid term life insurance plan for eligible employees
• Disability Benefits: Short-term and long-term disability coverage
• Wellbeing Programs: Numerous well-being programs to support your physical, emotional, and financial health
• Education Assistance: Free development courses and educational assistance programs
• Employee Discounts: arenaflex store discount and discount programs with participating partners
• Paid Time Off: Competitive PTO or vacation pay, as well as paid holidays throughout the calendar year

Career Growth Opportunities

At arenaflex, we are committed to helping our team members grow and develop in their careers. As a Customer Service Representative, you will gain valuable experience in the healthcare industry and develop skills that can lead to advancement opportunities within the organization. We invest in our people through training, development programs, and mentorship to help you reach your full potential.

Many of our leadership team members started in entry-level positions and grew their careers here. Your journey at arenaflex could include pathways to team lead roles, quality assurance positions, training and development roles, or specialized customer service functions.

Our Culture: Heart At Work

At arenaflex, our purpose guides everything we do: bringing our heart to every moment of your health. We are looking for team members who embody our Heart At Work Behaviors™ – individuals who are empowered to play a role in transforming our culture and accelerating our ability to innovate and deliver solutions.

We foster an environment where:

• Every voice matters and is heard
• Diversity and inclusion are celebrated
• Innovation and continuous improvement are encouraged
• Work-life balance is supported
• Personal and professional growth is prioritized

Join Our Mission

We are excited about the possibility of welcoming you to the arenaflex family. If you are ready to make a difference, embrace challenges, and be part of a team that truly cares about every member interaction, we encourage you to apply today.

Bring your heart to arenaflex. Every moment of health matters, and you could be the person who makes that moment special for our members.

We anticipate the application window for this opening will close on: 05/17/2024

Apply now and become part of something bigger than yourself. We can't wait to meet you!