**About arenaflex**
At arenaflex, we're dedicated to delivering exceptional health insurance services to over 1.6 million Ohioans, empowering them to achieve their best possible health and quality of life. As a leading health insurance provider, we're committed to innovation, excellence, and customer satisfaction. Our team of passionate professionals is driven by a shared vision to make a meaningful difference in the lives of our members. If you're a customer-focused individual with a passion for claims processing and a drive to succeed, we invite you to join our dynamic team as a Claims and Customer Care Specialist.
**Job Summary**
We're seeking an experienced Claims and Customer Care Specialist to join our team in a remote work-from-home opportunity. As a key member of our team, you'll be responsible for processing routine to moderately complex claims while providing exceptional customer service through various communication channels. This role requires a unique blend of technical skills, customer service expertise, and a passion for delivering high-quality results. If you're a motivated and detail-oriented professional with a strong background in customer service and claims processing, we encourage you to apply for this exciting opportunity.
**Responsibilities**
As a Claims and Customer Care Specialist at arenaflex, you'll have the opportunity to make a meaningful impact on our members' lives. Your key responsibilities will include:
* Processing routine claims while providing customer service via inbound call queues, ensuring timely and accurate resolution of member inquiries.
* Handling inbound calls and written inquiries from members, providers, clients, employers, and brokers, providing empathetic and knowledgeable support.
* Conducting claims or inquiry-related research under the direction of senior staff, utilizing your analytical skills to resolve complex issues.
* Assisting with projects as directed by management, demonstrating your ability to adapt to changing priorities and deadlines.
* Mentoring and training junior team members in claims processing and customer service, sharing your expertise and experience to help them grow and develop.
* Conducting complex claims research projects in response to inquiries and escalations, utilizing your technical skills and knowledge to deliver accurate and timely results.
* Providing troubleshooting support for claims issues, working collaboratively with internal stakeholders to resolve complex problems.
**Requirements**
To be successful in this role, you'll need to possess the following qualifications and skills:
* Associate degree in business, healthcare administration, communications, or a related field, or an equivalent combination of training and experience.
* 1-5 years of customer service and/or claims experience, preferably in a call center in the health or dental insurance industry.
* Basic to advanced Microsoft Office skills, depending on the level of the position.
* Knowledge of dental benefits, services, terminology, and American Dental Association coding.
* Understanding of standard customer service best practices and principles.
* Knowledge of the Health Insurance Portability and Accountability Act (HIPAA).
**Nice-to-Haves**
While not required, the following certifications are highly desirable:
* Certified Dental Billing Specialist (CDBS)
* Certified Dental Coder (CDC)
* Certified Dental Assistant (CDA)
**Benefits**
As a valued member of our team, you'll enjoy a comprehensive benefits package, including:
* Employee bonus program
* 401(k) with company match up to 4% and additional company contribution
* Health Savings Account with company matching contribution
* Excellent medical, dental, vision, life, and disability insurance
* Access to an Employee Assistance Program for counseling and coaching
* Company holidays and up to 16 PTO days in the first year, with options to carry over unused PTO
* Parental leave for eligible employees after 120 days of service
* Career development programs and classes
* Tuition reimbursement up to $5,250 per year
**Work Environment and Company Culture**
As a remote employee, you'll have the flexibility to work from home while still being part of a dynamic and supportive team. Our company culture is built on a foundation of innovation, collaboration, and customer satisfaction. We're committed to creating a work environment that's inclusive, diverse, and respectful, where every employee feels valued and empowered to succeed.
**How to Apply**
If you're a motivated and customer-focused professional with a passion for claims processing, we invite 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!