Experienced Customer Service Agent – Medical Authorization and Support

At arenaflex, we're dedicated to providing exceptional service to our partners and customers in the healthcare industry. As a key member of our team, you'll play a vital role in ensuring seamless communication and support for our clients, providers, and patients. If you're passionate about delivering top-notch customer service, have a strong understanding of medical terminology, and are eager to join a dynamic team, we encourage you to apply for this exciting opportunity.

Job Summary:

As an Experienced Customer Service Agent at arenaflex, you'll be responsible for processing high volumes of service authorization requests, conducting outbound communication with providers and patients, and responding to inbound calls from external customers. You'll work closely with our Care Management team to ensure accurate processing and resolution of requests, while maintaining a thorough understanding of company policies, procedures, and systems. If you're a motivated and detail-oriented individual with a passion for delivering exceptional customer service, we want to hear from you.

Key Responsibilities:

* Processes a high volume of service authorization requests received via fax, phone, and online portals, verifying member eligibility and benefits, and documenting relevant clinical and administrative information within the Authorization Tracking System (ATS).

• Forwards authorization requests to Care Management for clinical review and determination, as appropriate, and follows up with providers to obtain missing or additional information based on case requirements.
• Inputs service outcome details as provided by healthcare providers into the ATS.
• Conducts outbound communication with providers, provider office staff, pharmacies, and patients to ensure accurate processing and resolution of requests.
• Responds to a high volume of inbound calls from external customers, engaging professionally and effectively, utilizing call scripts, system information, and subject-matter knowledge to resolve inquiries.
• Maintains a thorough, up-to-date understanding of company policies, procedures, contractual obligations, relevant medical terminology (including infertility-related terminology), systems, and telephone protocols to deliver high-quality support.
• Appropriately escalates calls in accordance with established protocols and guidelines.
• Prepares prescription requests and submits approved prescriptions to partner pharmacies for fulfillment.
• Adheres strictly to HIPAA regulations when handling protected health information.
• Performs additional duties and responsibilities as assigned by management.

Minimum Qualifications:

* High school diploma or equivalent required.

• Minimum of three (3) years of customer service experience in a call center environment, or at least two (2) years of experience in a medical office setting.

Knowledge, Skills, and Abilities:

* Strong familiarity with medical terminology, as well as CPT and ICD-10 coding; prior experience is highly preferred.

• Working knowledge of HIPAA regulations is beneficial.
• Previous customer service experience within the healthcare or health insurance industry is preferred.

Why Join arenaflex?

* Collaborative and dynamic work environment

• Opportunities for career growth and professional development
• Comprehensive benefits package, including medical, dental, and vision insurance
• Generous paid time off and holidays
• Access to ongoing training and education programs
• Recognition and rewards for outstanding performance

What We Offer:

* Competitive salary and bonus structure

• Comprehensive benefits package, including medical, dental, and vision insurance
• Generous paid time off and holidays
• Access to ongoing training and education programs
• Recognition and rewards for outstanding performance
• Opportunities for career growth and professional development

How to Apply:

If you're a motivated and detail-oriented individual with a passion for delivering exceptional customer service, we encourage you to apply for this exciting opportunity. Please submit your resume and a cover letter outlining your experience and qualifications. We can't wait to hear from you!

Equal Employment Opportunity:

arenaflex is an equal employment opportunity employer and welcomes applications from diverse candidates. We are committed to creating an inclusive and respectful work environment that values diversity, equity, and inclusion. Apply for this job