**Experienced Customer Service Representative – Work From Home (arenaflex REMOTE WORK)**

**Join arenaflex, a leading healthcare company, in revolutionizing the way we deliver personalized, convenient, and affordable healthcare services. As an Experienced Customer Service Representative, you will be at the forefront of our mission to bring heart to every moment of our customers' health.** **About arenaflex** arenaflex is a dynamic and innovative company that is committed to delivering enhanced human-centric healthcare for a rapidly changing world. Our purpose is to bring our heart to every moment of our customers' health, and we believe that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose, empowering our employees to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions. **Work From Home Opportunity** We are seeking an Experienced Customer Service Representative to join our team in a work-from-home setting. As a remote employee, you will have the flexibility to work from the comfort of your own home, while still being an integral part of our team. This role requires a strong commitment to delivering exceptional customer service, and we are looking for someone who is passionate about making a difference in the lives of our customers. **Responsibilities** As an Experienced Customer Service Representative, you will be responsible for: * Maintaining a positive, empathetic, and professional attitude toward customers at all times * Responding promptly to customer inquiries and resolving customer complaints in a timely and effective manner * Communicating with customers through various channels, including phone, email, and chat * Processing orders, forms, applications, and requests in a accurate and efficient manner * Keeping records of customer interactions, transactions, comments, and complaints * Communicating and coordinating with colleagues as necessary to ensure seamless customer service * Providing feedback on the efficiency of the customer service process * Managing a team of junior customer service representatives (optional) **Key Responsibilities** * Answer questions and resolve issues based on phone calls/letters from members, providers, and plan sponsors * Triages resulting rework to appropriate staff * Provide excellent customer services for high volume in-bound provider calls for the Claims Inquiry/Claims Research team * Extensive claims research on multiple platforms to assist providers with payment questions * Provides the customer with related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc. * Uses customer service threshold framework to make financial decisions to resolve member issues * Explains member's rights and responsibilities in accordance with contract * Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system * Educates & assists providers on our self-service options * Assists providers with credentialing and re-credentialing and contracting questions and issues * Assists in compiling claim data for customer audits * Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals **Essential 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) **Preferred Qualifications** * Bachelor's degree in a related field * Experience in healthcare or customer service industry * Knowledge of healthcare regulations and laws * Experience with claims processing and medical billing **Education** * High School diploma or GED equivalent **What We Offer** * Competitive salary and benefits package * Opportunity to work from home in a flexible and dynamic environment * Comprehensive training program to ensure success in the role * Ongoing support and development opportunities to help you grow in your career * Collaborative and supportive team environment * Recognition and rewards for outstanding performance **How to Apply** If you are a motivated and customer-focused individual who is passionate about making a difference in the lives of our customers, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, through our website. **Note** arenaflex is an equal opportunity employer and welcomes applications from diverse candidates. We are committed to creating an inclusive and supportive work environment that values diversity, equity, and inclusion. Apply for this job