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Experienced Customer Service Representative – Medicare Appeal Process Support

Work from home Full-time role Hiring

At arenaflex, we're passionate about empowering better health outcomes through technology, services, and clinical expertise. Our mission is to innovate health solutions that deliver maximum value and impact, and we're looking for talented individuals to join our team of passionate professionals dedicated to being a vital partner for health solutions in the public sector. As a Customer Service Representative at arenaflex, you'll play a critical role in supporting the Medicare Appeal process by providing exceptional customer service, resolving customer inquiries and complaints, and utilizing your working knowledge of our services to meet productivity and quality standards. If you're a motivated and customer-focused individual with a passion for delivering outstanding results, we encourage you to apply for this exciting opportunity.

Job Summary:

The Customer Service Representative is responsible for supporting the Medicare Appeal process by answering incoming telephone calls, resolving customer questions, complaints, and requests, adhering to internal policies and procedures, and utilizing working knowledge of the organization's services to meet productivity and quality standards.

Key Responsibilities:

* Develops and maintains working knowledge of internal policies, procedures, and services (both departmental and operational)

  • Utilizes automated systems to log and retrieve information, performs accurate and timely data entry of electronic faxes
  • Receives inquiries from customers or providers by telephone, email, fax, or mail and communicates response within required turnaround times
  • Responds to telephone inquiries and complaints in a prompt, accurate, and courteous manner following standard operating procedures
  • Interacts with hospitals, physicians, beneficiaries, or other program recipients
  • Investigates and resolves or reports customer problems, identifies and escalates difficult situations to the appropriate party
  • Meets or exceeds standards for call volume and service level per department guidelines
  • Initiates files by collecting and entering demographic, provider, and procedure information into the system
  • Serves as liaison between the Review Supervisors and external providers
  • Maintains logs and documents disposition of incoming and outgoing calls

Requirements:

* High School diploma or equivalent

  • 2+ year's customer service/telephone experience in a similar call center environment and/or industry
  • Must have ability to effectively communicate with team members and external customers
  • Must have ability to research and resolve issues related to Medicaid program and service eligibility
  • Bilingual (Spanish/English)

Preferred Qualifications/Experience:

* Previous experience in the medical office or other medical setting preferred

  • General knowledge of eligibility verification (Medicaid eligibility and program requirements for specific program of focus preferred)
  • Knowledge of CPT and HCPCS codes preferred
  • PC proficiency to include Microsoft Office Suite
  • Experience with Microsoft programs

Benefits:

At arenaflex, we're committed to providing a comprehensive benefits package that supports your career growth and overall well-being. Our benefits include:

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

Compensation:

The pay range for this position is $15.85 - $18.20. Based on our compensation program, an applicant's position placement in the pay range will depend on various considerations, such as years of applicable experience and skill level.

Why Join arenaflex?

We're a team of experienced and caring leaders, clinicians, pioneering technologists, and industry professionals who come together to redefine expectations for the healthcare industry. State and federal healthcare agencies, providers, and employers turn to us as their vital partner to ensure better healthcare and improve health outcomes. We do this through our people. You'll have meaningful work that genuinely improves people's lives across the country. We're a company that cares about our employees, and we give you the tools and encouragement you need to achieve the finest work of your career.

Work Environment and Company Culture:

As a remote Customer Service Representative, you'll have the flexibility to work from home and enjoy a dynamic and supportive work environment. Our company culture is built on collaboration, innovation, and a passion for delivering exceptional results. We're committed to providing ongoing training and development opportunities to help you grow and succeed in your career.

How to Apply:

If you're a motivated and customer-focused individual with a passion for delivering outstanding results, we encourage you to apply for this exciting opportunity. Please visit our website at arenaflex.com/careers/ to submit your application.

Equal Opportunity Employer:

arenaflex is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran or any other status protected by applicable Federal, State or Local law. Apply for this job

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