Experienced Customer Service Representative (Remote) – Quality Improvement and Care Management

At arenaflex, we're on a mission to revolutionize the way healthcare is delivered across the country. As a rapidly growing national quality improvement and care management organization, we're committed to ensuring that over 20 million people receive the right care, at the right time, in the right setting. We're seeking an experienced Customer Service Representative to join our team and help us shape the future of healthcare.

About arenaflex

arenaflex is a people-focused, mission-driven organization that's dedicated to improving lives through healthcare quality and clinical expertise. We believe that our employees are the key to our success, and we're committed to providing them with the training, support, and resources they need to excel in their careers. Our benefits package is designed to provide our employees and their families with additional protection, security, and support, both in and out of the workplace.

Why Join arenaflex?

As a Customer Service Representative at arenaflex, you'll have the opportunity to make a real difference in the lives of individuals across the country. You'll be part of a dynamic team that's passionate about delivering exceptional customer service and improving healthcare outcomes. Our work environment is fast-paced and challenging, but we're committed to supporting our employees every step of the way.

Key Responsibilities

As a Customer Service Representative, you'll be responsible for supporting the prior authorization process by answering incoming telephone calls, resolving customer questions, complaints, and requests. You'll adhere to internal policies and procedures and utilize your working knowledge of arenaflex's services to meet productivity and quality standards. Your key responsibilities will include:

• Developing and maintaining working knowledge of internal policies, procedures, and services (both departmental and operational)
• Utilizing automated systems to log and retrieve information, and performing accurate and timely data entry of electronic faxes
• Receiving inquiries from customers or providers by telephone, email, fax, or mail, and communicating responses within required turnaround times
• Responding to telephone inquiries and complaints in a prompt, accurate, and courteous manner, following standard operating procedures
• Interacting with hospitals, physicians, beneficiaries, or other program recipients
• Investigating and resolving or reporting customer problems, identifying and escalating difficult situations to the appropriate party
• Meeting or exceeding standards for call volume and service level per department guidelines
• Initiating files by collecting and entering demographic, provider, and procedure information into the system
• Serving as a liaison between Review Supervisors and external providers
• Maintaining logs and documents disposition of incoming and outgoing calls

Essential Qualifications

To be successful in this role, you'll need:

• A High School diploma or equivalent
• Medical terminology course(s) helpful
• Knowledge of:

+ Medical terminology + Health insurance industry

• Ability to:

+ Speak English fluently enough to be clearly understood over the telephone + Use phone system effectively + Research and investigate + Follow confidentiality policies and procedures + Navigate and use electronic equipment and systems easily and proficiently + Multitask on a personal computer while conducting telephone conversations + Work in a fast-paced call center environment + Remain calm and courteous when handling difficult calls and requests

• Skills:

+ Bilingual Spanish-English a plus + Effective verbal and listening skills to provide courteous and professional customer service + Effective PC skills, including electronic mail, intranet, and industry-standard applications

Preferred Qualifications

While not required, we prefer candidates with:

• 2+ years of customer service/telephone experience in a similar call center environment and/or industry
• Experience working in a fast-paced call center environment
• Knowledge of electronic medical records (EMRs) and other healthcare-related software systems

What We Offer

As a Customer Service Representative at arenaflex, you'll enjoy a comprehensive benefits package, including:

• Comprehensive health plans
• Paid time off
• Retirement savings
• Corporate wellness
• Educational assistance
• Corporate discounts
• And more!

How to Apply

If you're passionate about delivering exceptional customer service and improving healthcare outcomes, we encourage you to apply for this exciting opportunity. Please submit your application through our website, and we'll be in touch to discuss your qualifications further.

Equal Opportunity Employer

arenaflex is an Equal Opportunity Employer. We're committed to creating a diverse and inclusive work environment that values and respects the contributions of all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Apply for this job