Remote Sr. Customer Service Advocate – Healthcare Industry Expertise

At arenaflex, we're committed to delivering exceptional customer experiences that exceed our patients' and members' expectations. As a Remote Sr. Customer Service Advocate, you'll play a vital role in driving our organization's success by providing top-notch support through various call campaigns. If you're passionate about delivering outstanding customer service, have a knack for problem-solving, and thrive in a dynamic environment, we want to hear from you!

About arenaflex

arenaflex is a leading healthcare organization dedicated to improving the lives of our patients and members. We're passionate about delivering innovative solutions that address the complex needs of our clients. Our team is comprised of dedicated professionals who share a common goal: to provide exceptional care and support to those who need it most.

Job Summary

As a Remote Sr. Customer Service Advocate, you'll be responsible for conducting outbound and inbound calls to support various call campaigns, including attribution, disruption, appointment scheduling, medication adherence, and more. You'll interact with patients, members, health plans, and providers, ensuring that our organization's overall performance and campaign success rate are met. This role requires a unique blend of technical skills, critical thinking, and excellent communication abilities.

Key Responsibilities

* Conduct outbound member calls to support various call campaigns, including: + Attribution – PCP confirmation or assist member to select PCP + Disruption – notify patient of health plan termination and assist with connecting to a broker + Appointment scheduling – assisting patient to schedule annual wellness visit + Medication adherence – discussing medication supply and connecting to health plan to enroll in mail order delivery

• Conduct 3-way calls with patients and health plans for attribution call campaigns
• Handle member inbound calls to address inquiries for Medicare FFE members for providers enrolled in ACO reach
• Complete detailed call documentation that is included in quarterly CMS reporting
• Conduct outbound 'secret shopper' calls to confirm appointment availability at practice locations
• Conduct outbound calls to dialysis centers to confirm required information has been submitted to CMS and capture the date of submission
• Conduct outbound calls within CMS timeframe requirements to notify members of medication approval
• Ability to clearly understand call campaign objectives
• Ability to access multiple systems and navigate while interacting with patients
• Ability to shift between call campaigns without quality impacted
• Ability to think critically when determining final call disposition
• Complete accurate and detailed call documentation
• Troubleshoot system/data issues to ensure the correct population is included in the call campaign
• Escalate patient/member concerns appropriately to management
• Maintain a calm demeanor whenever interacting with patients/members
• Ability to adapt and think quickly to respond appropriately to member questions and/or concerns
• Understand target success rate of each call campaign and drive performance to meet the expectation
• Complete outbound calls timely and in accordance with the performance standards established within the customer service department
• Facilitate communication through the Language Assistance Program (for members who are not English proficient) of the various plans, and/or arrange for interpreter, including interpretive services for the hearing impaired
• Forward calls as appropriate to supervisor or other staff for further response or follow up
• Ensure confidentiality of all hard copy, electronic, and verbal communication, and adhere to organization's policies related to privacy and disclosure
• Promote a positive image of the organization and the department in all aspects of communication and contact
• Participate in regular training exercises to maintain program knowledge
• Perform other duties as assigned

Other Job Functions

* Understand, adhere to, and implement the Company's policies and procedures

• Provide excellent customer service skills, including consistently displaying awareness and sensitivity to the needs of internal and/or external clients
• Take personal responsibility for personal growth, including acquiring new skills, knowledge, and information
• Engage in excellent communication, including listening attentively and speaking professionally
• Set and complete challenging goals
• Demonstrate attention to detail and accuracy in work product

Required Qualifications

* Minimum of 12 months experience in Customer/Member services or related function in a healthcare organization

• Experience with conducting member outbound calls
• Experience in a managed care environment preferred
• Demonstrated experience and expertise in customer service skills, including:

+ Excellent verbal and written communication skills + Handling difficult communications with skill to achieve positive outcome + Clear and concise targeted communications focused on the customer

• Bilingual (English/Spanish) preferred

Education/Licensure

* Minimum educational level: high school diploma

• Some college-level coursework preferred

Location

Remote – California

Pay Range

$18.40 - $22.10 Salary range shown is a guideline. Individual compensation packages can vary based on factors unique to each candidate, such as skill set, experience, and qualifications.

What We Offer

* Competitive salary range

• Opportunity to work in a dynamic and innovative environment
• Comprehensive benefits package
• Professional development and growth opportunities
• Collaborative and supportive team environment
• Flexible work arrangements, including remote work options

How to Apply

If you're a motivated and customer-focused individual who is passionate about delivering exceptional service, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, through our website. Apply Now! We're excited to hear from you and look forward to reviewing your application! Apply for this job