Experienced Healthcare Customer Service Advocate – Remote Position

Join arenaflex and embark on a fulfilling career in healthcare, where you'll have the opportunity to make a meaningful impact on the lives of our clients and their members. Are you passionate about delivering exceptional customer service and making a difference in the healthcare industry? Do you have a strong understanding of healthcare terminology and a keen eye for detail? If so, we invite you to join arenaflex as a Healthcare Customer Service Advocate, where you'll play a vital role in taking member services calls and providing top-notch support to our clients and their members.

About the Role:

As a Healthcare Customer Service Advocate, you will be a valued member of our team, responsible for managing inbound and outbound calls, responding to member and provider inquiries with professionalism and accuracy. You will provide information on membership options, benefits, and account status on behalf of our clients, ensuring their satisfaction on calls. Your solid understanding of healthcare claims, benefits, and policy process flows, as well as your knowledge of healthcare terminology, including ICD-9 and ICD-10 coding, will enable you to accurately and efficiently read and relay information to members.

Job Type and Schedule:

This is a full-time, 100% remote position, requiring a strong internet connection and a quiet dedicated work area. The schedule is Monday to Friday, 11:00 am to 8:00 pm EST (10:00 am to 7:00 pm CT).

Key Responsibilities:

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Member and Provider Support:

Manage inbound and outbound calls, responding to member and provider inquiries with professionalism and accuracy. Provide information on membership options, benefits, and account status on behalf of our clients.

Application Processing:

Review, verify, and process membership applications efficiently, ensuring completeness and accuracy of all required information.

Data Entry and Management:

Maintain and update member information in our CRM systems, ensuring data integrity and accuracy across multiple client accounts.

Multitasking:

Handle multiple client accounts and responsibilities simultaneously, managing calls, processing paperwork, and updating databases without compromising on quality.

Quality Assurance:

Perform regular audits of member data to ensure compliance with client standards and industry regulations, identifying and rectifying any discrepancies.

Collaboration:

Coordinate with other teams within arenaflex, including IT, customer service, and quality assurance, to resolve issues and enhance service delivery for our clients.

Process Improvement:

Continuously identify opportunities to streamline processes and contribute to initiatives that improve client satisfaction and operational efficiency.

Job Description:

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Handle Customer Service Inbound Calls:

Receive and respond to calls primarily from members, providers, and occasionally other health plans. Provide information on the status of authorization requests, including both inpatient and outpatient services. Maintain a high level of professionalism and customer service in all interactions. Resolve issues promptly and effectively, ensuring customer satisfaction.

Authorization Management:

Address and manage re-direct requests. Handle requests to re-fax authorization documents as needed.

Lines of Business:

General Membership, Health Plan Providers, ETC.

Documentation and Compliance:

Accurately document call interactions and outcomes in the appropriate systems. Ensure compliance with all relevant regulations and guidelines.

Qualifications:

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Educational Background:

High School Diploma or General Education Degree (GED) required.

Technical Skills:

+ At least 2-4 years of experience in processing health insurance, customer service, call center, medical office, or other healthcare-related field + Healthcare Medical Terminology + Proficiency in Microsoft Office Suite (Word, Excel, Outlook) + Experience with CRM systems or membership databases + Strong typing and data entry skills, with the ability to manage multiple systems simultaneously

Other Qualifications:

+ Attention to Detail: Keen ability to detect and correct errors in data, ensuring high standards of accuracy and consistency. + Multitasking Ability: Proven track record of effectively managing multiple tasks and priorities in a busy work environment. + Communication Skills: Excellent verbal and written communication skills, with the ability to articulate information clearly and confidently to members. + Problem-Solving Skills: Strong analytical capabilities with a focus on identifying issues and implementing solutions quickly and effectively. + Customer Service Orientation: A passion for delivering exceptional service to clients and their members, aligning with arenaflex's commitment to excellence.

Work from Home Requirements:

* High Speed Internet of 25MBPS download and 5MBPS upload. You will be required to provide proof of a speed test.

• Ability to directly hardwire equipment to your modem
• Required to have a quiet dedicated work area.

What We Offer:

* Paid training period

• Medical, Dental, Life, Vision, HSA, 401K
• PTO
• Equipment provided

Company Overview:

arenaflex LLC is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. arenaflex provides claims processing services, including digital transformation, claims adjudication, and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans' members and providers. The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement, and satisfaction with plans' members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance, and automation of claims operations for its clients. arenaflex LLC is headquartered in Tampa, operates 10 regional offices throughout the U.S., and has a wholly owned global delivery center in the Philippines. arenaflex LLC provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

Join arenaflex Today:

If you're passionate about delivering exceptional customer service and making a difference in the healthcare industry, we invite you to apply for this exciting opportunity. As a Healthcare Customer Service Advocate at arenaflex, you'll have the chance to work with a talented team, develop your skills, and contribute to the success of our clients and their members. Apply now and take the first step towards a fulfilling career in healthcare! Apply for this job