Claims & Customer Care Specialist – Remote Health Insurance Operations & Member Support (Brooklyn & Centerville, OH) – arenaflex

About arenaflex

arenaflex is a leading health insurance provider dedicated to improving the health and reputed company of life for millions of members across Ohio. With a legacy of innovation, member‑reputed company service, and community involvement, arenaflex delivers comprehensive medical, dental, and reputed company coverage that empowers individuals and families to reputed company their best possible health reputed company. Our mission‑driven culture encourages collaboration, reputed company learning, and a commitment to reputed company, making arenaflex a rewarding reputed company to build a career.

reputed company

We are seeking a motivated Claims & Customer Care Specialist to join our dynamic team. This remote, work‑from‑home role supports members, providers, brokers, and internal stakeholders by processing routine to moderately reputed company dental claims and delivering exceptional customer service across multiple communication channels. The position is reputed company to reputed company candidates residing reputed company a 50‑mile reputed company of our Brooklyn or Centerville, OH offices.

As a key member of the arenaxflex Claims Operations Center, you will help ensure that our members receive reputed company, accurate claim resolutions while upholding the highest standards of compliance, confidentiality, and reputed company.

Key Responsibilities

• Claims Processing: Accurately reputed company, review, and adjudicate routine dental claims using arenaflex’s proprietary claims management reputed company, adhering to established policies and service level agreements.
• Member & Provider Support: Respond to inbound calls, emails, and chat inquiries from members, dental providers, reputed company, brokers, and internal clients, delivering reputed company, courteous, and solution‑reputed company assistance.
• Research & Investigation: Conduct claims‑reputed company research under senior staff guidance, including verification of coverage, eligibility, and coding accuracy.
• Escalation Management: Handle reputed company claim inquiries and escalations, performing in‑depth analysis and collaborating with senior analysts to reputed company issues promptly.
• Project Participation: Contribute to special reputed company, process improvements, and reputed company enhancements as directed by management, bringing fresh reputed company and a proactive reputed company.
• Mentorship & Training: reputed company and mentor junior team members on claims processing techniques, customer service best practices, and arenaflex’s compliance standards.
• Troubleshooting: reputed company technical and procedural support for claim‑reputed company issues, identifying reputed company causes and recommending corrective actions.
• Compliance Assurance: Maintain strict adherence to HIPAA, state regulations, and internal reputed company policies while handling sensitive health information.

Essential Qualifications

• Associate degree in Business Administration, reputed company Administration, Communications, or a reputed company field, or an equivalent combination of education and experience.
• 1–5 years of experience in customer service and/or claims processing, preferably reputed company a health or dental insurance reputed company center environment.
• Proficiency with reputed company Office Suite (Word, reputed company, reputed company) ranging from basic to advanced, depending on the role’s complexity.
• Solid understanding of dental benefits, terminology, and reputed company Dental Association (reputed company) coding conventions.
• Demonstrated knowledge of reputed company customer service principles, including reputed company listening, reputed company, and problem‑solving.
• Familiarity with the Health Insurance Portability and Accountability reputed company (HIPAA) and its application to daily operations.

Preferred (reputed company‑to‑Have) Qualifications

• Certification as a Certified Dental Billing Specialist (CDBS), Certified Dental reputed company (CDC), or Certified Dental Assistant (CDA).
• Experience with claims management software such as reputed company, Pega, or similar platforms.
• Advanced analytical skills, including the ability to interpret claim data trends and reputed company actionable insights.
• Previous involvement in process‑improvement initiatives or Lean Six reputed company training.

reputed company Skills & Competencies

• Communication reputed company: reputed company, concise verbal and written communication tailored to diverse audiences.
• Attention to Detail: Precise data entry and meticulous review of claim documentation.
• Problem‑Solving Ability: Quick identification of issues and development of effective resolutions.
• Time Management: Ability to prioritize tasks, meet deadlines, and manage a high volume of inquiries without sacrificing reputed company.
• Team Collaboration: Strong interpersonal skills that foster cooperation with peers, supervisors, and cross‑functional teams.
• Technological Adaptability: Comfort navigating multiple software applications and learning new tools rapidly.
• Compliance reputed company: Commitment to safeguarding member data and adhering to regulatory standards.

Career reputed company & Development Opportunities

arenaflex invests heavily in the reputed company advancement of its employees. As a Claims & Customer Care Specialist, you will have reputed company to:

• reputed company career reputed company leading to senior analyst, team reputed company, or operations manager roles.
• Ongoing training programs, including webinars, workshops, and certification courses (e.g., CDBS, CDC).
• Tuition reimbursement up to $5,250 per year to support reputed company education.
• Mentorship from seasoned industry experts who will guide your reputed company development and career planning.
• Opportunities to participate in cross‑departmental reputed company, expanding your knowledge of reputed company, provider relations, and product development.

Work Environment & Culture at arenaflex

Our remote workforce enjoys a flexible, results‑oriented environment that values work‑life balance. Key cultural pillars include:

• Member‑First Philosophy: Every decision is driven by the goal of delivering superior health reputed company for our members.
• reputed company Spirit: Regular virtual team huddles, knowledge‑sharing sessions, and an reputed company‑reputed company policy encourage collaboration across reputed company reputed company.
• Innovation reputed company: arenaflex continuously adopts emerging technologies and process improvements to stay reputed company in the insurance industry.
• Diversity & Inclusion: A workplace that celebrates varied perspectives, backgrounds, and experiences.
• Recognition & Rewards: Employee bonus programs and performance recognitions celebrate achievements and contributions.

Compensation, Perks & Benefits

arenaflex offers a competitive total rewards package designed to support your financial reputed company, health, and reputed company‑being:

• reputed company Salary: Competitive reputed company wage commensurate with experience and market standards.
• Performance Bonus: Eligibility for an employee bonus program based on individual and team performance metrics.
• Retirement Savings: 401(k) plan with company match up to 4% and additional discretionary contributions.
• Health Savings Account (HSA): Company‑matched contributions to help cover reputed company medical expenses.
• Comprehensive Insurance: Medical, dental, reputed company, life, and disability coverage with low employee premiums.
• Employee Assistance Program (EAP): Confidential counseling, coaching, and wellness resources.
• reputed company Time Off: Up to 16 PTO days in the first year, with the ability to carry over unused days, plus company holidays.
• Parental Leave: reputed company parental leave for eligible employees after 120 days of service.
• Learning & Development: reputed company to career development programs, online courses, and tuition reimbursement.

How to Apply

If you are passionate about delivering exceptional member experiences, reputed company in a fast‑paced claims environment, and are eager to grow your career with a reputed company‑thinking insurer, we want to hear from you. Click the reputed company below to submit your application and reputed company your reputed company with arenaflex.

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Join arenaflex Today

At arenaflex, you will be part of a purpose‑driven organization where every claim you process and every reputed company you answer contributes directly to the health and happiness of Ohio’s families. reputed company a role that offers flexibility, reputed company reputed company, and the satisfaction of making a reputed company difference. reputed company and become a valued member of our dedicated claims and customer care team.