**Join arenaflex in Revolutionizing Healthcare Customer Service**
At arenaflex, we're committed to delivering exceptional healthcare experiences that put our customers at the forefront. As a Customer Service Representative, you'll play a vital role in shaping the future of healthcare by providing top-notch support to our customers. If you're passionate about delivering outstanding customer experiences and have a knack for resolving complex issues, we want to hear from you!
**About arenaflex**
arenaflex is a leading healthcare company dedicated to transforming the way we deliver care. Our purpose is simple: to bring our heart to every moment of your health. We believe that how we deliver our services is just as important as what we deliver. Our Heart At Work Behaviors support this purpose, empowering our team members to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make healthcare more personal, convenient, and affordable.
**Work from Home Opportunity**
As a Customer Service Representative, you'll have the flexibility to work from home, enjoying a comfortable and productive work environment. This role requires a strong internet connection, and we provide a 6 ½ foot long ethernet cord to ensure a seamless connection. With a high-speed internet access of 25 mbps or higher, you'll be able to focus on delivering exceptional customer experiences without any connectivity issues.
**Responsibilities**
As a Customer Service Representative, you'll be responsible for:
* Maintaining a positive, empathetic, and professional attitude toward customers at all times
* Responding promptly to customer inquiries
* Communicating with customers through various channels
* Acknowledging and resolving customer complaints
* Knowing our products inside and out so that you can answer questions
* Processing orders, forms, applications, and requests
* Keeping records of customer interactions, transactions, comments, and complaints
* Communicating and coordinating with colleagues as necessary
* Providing feedback on the efficiency of the customer service process
* Managing a team of junior customer service representatives
**Position Summary**
As a Customer Service Representative, you'll be the first point of contact for our customers, answering questions and resolving issues based on phone calls, letters, and emails from members, providers, and plan sponsors. You'll provide excellent customer service for high-volume inbound provider calls, conducting extensive claims research on multiple platforms to assist providers with payment questions.
**Key Responsibilities**
* Answer questions and resolve issues based on phone calls, letters, and emails from members, providers, and plan sponsors
* Triages resulting rework to appropriate staff
* Provide excellent customer service for high-volume inbound provider calls
* Conduct extensive claims research on multiple platforms to assist providers with payment questions
* Provides the customer with related information to answer unasked questions
* 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 and 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 Oklahoma 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)
**Education**
* High School diploma or GED equivalent
**What We Offer**
* Competitive salary and benefits package
* Opportunity to work from home with a flexible schedule
* Comprehensive training program to ensure your success
* Collaborative and supportive work environment
* Career growth opportunities and learning benefits
* Recognition and rewards for outstanding performance
**How to Apply**
If you're passionate about delivering exceptional customer experiences and have a knack for resolving complex issues, we want to hear from you! Apply now to join our team of dedicated professionals at arenaflex.
Apply Now