Experienced Part-Time Remote Customer Service Representative - Work from Home Opportunity at arenaflex

At arenaflex, we're committed to delivering exceptional customer experiences that exceed our members' expectations. As a Part-Time Remote Customer Service Representative, you'll play a vital role in providing top-notch support to our members, providers, and plan sponsors. If you're passionate about delivering outstanding customer service and have a strong work ethic, we want to hear from you!

About arenaflex

arenaflex is a leading healthcare company dedicated to transforming the way we deliver healthcare services. Our mission is to make healthcare more personal, convenient, and affordable for our members. We're committed to putting our heart into every moment of our members' health, and we're looking for talented individuals like you to join our team.

Our Heart At Work Behaviors

At arenaflex, we believe that our Heart At Work Behaviors are just as important as our purpose. These behaviors support our commitment to delivering exceptional customer experiences and driving innovation in healthcare. They include:

• Customer Focus: We're passionate about delivering outstanding customer experiences that exceed our members' expectations.
• Collaboration: We work together as a team to achieve our goals and deliver exceptional results.
• Accountability: We take ownership of our work and are accountable for our actions.
• Innovation: We're committed to driving innovation in healthcare and finding new ways to deliver exceptional customer experiences.
• Integrity: We operate with integrity and transparency in all our interactions.

Job Summary

As a Part-Time Remote Customer Service Representative, you'll be responsible for providing exceptional customer service to our members, providers, and plan sponsors. You'll answer questions, resolve issues, and provide related information to answer unasked questions. You'll also process claim referrals, new claim handoffs, nurse reviews, complaints, and appeals via our target system.

Key Responsibilities

* Answer questions and resolve issues based on phone calls/letters from members, providers, and plan sponsors.

• Triages resulting rework to appropriate staff.
• Provide excellent customer service for high-volume inbound provider calls for the Claims Inquiry/Claims Research team.
• Extensive claims research on multiple platforms to assist providers with payment questions.
• Provides the customer with related information to answer unasked questions, e.g., additional plan details, benefit plan details, member self-service tools, etc.
• Uses customer service threshold framework to make financial decisions to resolve member issues.
• Explains member's rights and responsibilities in accordance with contract.
• Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance, and appeals (member/provider) via target system.
• Educates & assists providers on our self-service options.
• Assists providers with credentialing and re-credentialing and contracting questions and issues.
• Assists in compiling claim data for customer audits.
• Determines medical necessity, applicable coverage provisions, and verifies member plan eligibility relating to incoming correspondence and internal referrals.

Required Qualifications

* MUST live in the state of Florida full-time.

• Familiarity with Microsoft Office products.
• Experience in highly transactional call center environment.
• Excellent customer service and critical thinking.
• High-speed internet access (25 mbps or higher) and consistent connection.
• Work location must be set up with a direct connection to the router (NOT Wi-Fi). We provide a 6 ½ foot long ethernet cord, if the distance is further, you will be required to provide your own ethernet cable.

Education

* High School diploma or GED equivalent.

Work Schedule

* This position is work from home and you must live in the State of Florida.

• Must be able to attend 4 weeks of training (virtual) between the hours of 8-5 EST.
• After training, the permanent schedule is an Monday-Friday and can start as early as 8 am EST and end as late as 7 pm EST.

Pay Range

* The typical pay range for this role is: $17.00 ? $25.15.

• This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography, and other relevant factors.

Benefits

* In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.

• The Company offers a full range of medical, dental, and vision benefits.
• Eligible employees may enroll in the Company's 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.
• The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long-term disability benefits.
• CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.
• As for time off, Company 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 consistent with relevant state law and Company policies.

How to Apply

If this role sounds like a perfect fit, don't hesitate. Apply today and let's build the future together. Apply To This Job

We Want to Hear From You!

At arenaflex, we're passionate about delivering exceptional customer experiences that exceed our members' expectations. If you're passionate about delivering outstanding customer service and have a strong work ethic, we want to hear from you! Apply for this job