Join arenaflex, a leading healthcare company dedicated to delivering innovative solutions that improve the lives of our customers. As a key member of our collaborative team, you will play a vital role in shaping the customer experience by providing exceptional support and guidance to individuals navigating our healthcare plans, devices, and resources.
**About arenaflex**
arenaflex is a forward-thinking company that shares a singular purpose: to carry our heart to every aspect of our customers' wellbeing. This purpose drives our commitment to delivering human-driven healthcare solutions that make a meaningful impact in a rapidly changing world. At arenaflex, 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 every individual who works with us to feel enabled by the role they play in changing lives and accelerating our ability to develop and deliver solutions that make healthcare more personal, accessible, and affordable.
**Position Overview**
As a Customer Service Representative, you will be the face of arenaflex, influencing individuals' service experience through the way customer care requests and issues are handled via phone, web, or written correspondence. You will connect with, counsel, and educate individuals based on their unique needs, preferences, and understanding of arenaflex plans, devices, and resources to guide them along a path to better health.
**Key Responsibilities**
* Respond to questions and resolve issues based on calls/letters from individuals, suppliers, and plan sponsors
* Escalate emergencies to the appropriate staff
* Record and track contacts with individuals, suppliers, and plan sponsors
* Guide the individual through their plan of benefits, arenaflex strategy, and methods, as well as knowing about resources to comply with any regulatory rules
* Make a personal connection with our individuals by listening and engaging with the individual to support their best health
* Take responsibility to understand the individual's needs by building a trusting and caring relationship with the individual
* Expect client needs and provide related information to address unasked questions, such as extra plan details, benefit plan details, individual self-service tools, etc.
* Utilize customer support software to pursue financial decisions to resolve individual issues
* Make sense of individual limitations based on contract
* Process claim references, new case handoffs, nurture surveys, complaints (individual/supplier), complaint, and requests (individual/supplier) via target system
* Teach suppliers on our self-service options; Help suppliers with credentialing and re-credentialing issues
* Answer demands received from arenaflex's Regulation Record Place regarding litigation; claims Handles broad document audit demands
* Aid in the preparation of protest pattern reports. Help with incorporating claim information for client reviews
* Decide clinical needs, relevant inclusion arrangements, and checks individual plan qualification concerning approaching correspondence and internal references
* Handle approaching requests for claims and pre-approvals not handled by Clinical Case Management
* Perform review of individual claim history to ensure accurate tracking of benefit maximums and coinsurance/deductible
* Perform review of individual claim history to ensure precise tracking of benefit maximums and coinsurance/deductible
* Perform financial data support as needed
* Utilize relevant system tools and resources to create quality letters and calculation sheets due to requests received
**Required Capabilities**
* Customer service experience in a transactional environment, such as a call center or retail store, demonstrating ability to be empathetic and compassionate
* Experience in a production environment
* Ability to perform multiple tasks to efficiently complete responsibilities
* Understanding of clinical terminology
* Capable oral and written communication skills
* Capable with Microsoft Word and Outlook
* Ability to maintain accuracy and production standards
* Transferable skills
* Technical skills
* Critical thinking skills
* Empathy and accuracy
**Logical Abilities**
This pay range addresses the base hourly rate or base yearly full-time compensation for all situations in the job grade within which this position falls. The actual base compensation offer will depend on various factors including experience, education, location, and other significant elements.
**Benefits and Perks**
In addition to your compensation, enjoy the benefits of working with a company that puts its heart into caring for our partners and our communities. arenaflex offers a full range of clinical, dental, and vision benefits. Qualified employees may enroll in the company's 401(k) retirement savings plan, and a Stock Purchase Plan is also available for qualified employees. arenaflex provides a fully paid term life insurance plan to qualified employees, and short-term and long-term disability benefits. arenaflex also offers various wellness programs, education assistance, free development courses, a CVS store discount program with participating partners. Regarding downtime, arenaflex employees enjoy Paid Time Off ("PTO") or vacation pay, as well as paid holidays throughout the calendar year. Number of paid holidays, sick time, and other time off are provided consistently with relevant state regulation and Company policies.
**We Encourage You to Apply!**
Even if you feel you're not a perfect match, we'd still love to hear from you. We are looking for great people to join our friendly team.