Experienced Customer Experience Representative III – Remote Customer Support

Join our dynamic team at arenaflex and embark on a rewarding career as an Experienced Customer Experience Representative III. This role offers a fantastic work environment, a competitive salary, and opportunities for growth and development. As a key member of our customer support team, you will be responsible for providing exceptional service to our members and providers, resolving issues, and identifying opportunities to improve our customer experience.

About arenaflex

arenaflex is a leading healthcare organization dedicated to providing high-quality services to our members and providers. We are committed to delivering exceptional customer experiences, and we are seeking a talented and passionate individual to join our team. Our company culture values diversity, inclusion, and teamwork, and we offer a supportive and dynamic work environment.

Job Summary

As an Experienced Customer Experience Representative III, you will be responsible for providing customer support and stellar service to meet the needs of our members and providers. You will resolve issues and address needs fairly and effectively, while demonstrating arenaflex values in your actions. You will provide product and service information, identify opportunities to improve our member and provider experiences, and represent member/provider issues in areas involving member/provider impact and engagement.

Key Responsibilities

* Provide service support to members and/or providers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off-phone work supporting our Medicaid, Medicare, and/or Marketplace business.

• Handles escalated calls on behalf of management.
• Provides excellent customer service for all call center communication channels.
• Accurately documents all member/provider communication.
• Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time and/or weekends, as needed.
• Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations.
• Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests, and identify the customer's needs.
• Achieves individual performance goals established for this position in the areas of call quality, attendance, and scheduled adherence.
• Engages and collaborates with other departments.
• Demonstrates personal responsibility and accountability by taking ownership of the call/issue and following it through to resolution, on behalf of the customer, in real time or through timely follow-up with the customer.
• Supports member needs for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other areas including very complex issues. Conducts initial research and works to immediately resolve issues. Appropriately escalates issues based on established risk criteria.
• Supports provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing, and other areas including the most complex issues. Conducts initial research and works to immediately resolve issues. Appropriately escalates issues based on established risk criteria.
• Proficient in three or more lines of business (for example, Medicare, Medicaid, Marketplace, MMP) for members services, provider services, and member retention.
• Responds to incoming calls from providers on a variety of issues of varying complexity, including highly complex or executive issues.
• Completes research for state, legislative, or regulatory inquiries as applicable.
• Gathers information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions.
• Achieves individual performance goals as it relates to call center objectives.
• Proactively engages and collaborates with other departments as required.
• Demonstrates personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations.
• Assists with formal training needs of other employees along with new hire or training classes as needed.
• Supports provider and member needs for a wide variety of inquiries involving member eligibility, and covered benefits.
• Provides inquiry assistance involving claims, authorizations, appeals, contracting, credentialing, and other provider-related issues.
• Supports other inquiry areas including the most complex issues.
• Conducts initial research and works to immediately resolve issues.
• Appropriately escalates issues based on established risk criteria.
• Recommends and implements programs to support member needs.
• Resolves member inquiries and complaints fairly and effectively to ensure member retention.
• Responds to incoming calls from members and providers.
• Conducts member satisfaction assessment services and other member surveys as applicable and based on business needs.
• Assist other retention or inbound functions as dictated by service level requirements.
• Remains professional and courteous in verbal and written communications, utilizing concise and effective language at all times.

Essential Qualifications

* Associate's Degree or equivalent combination of education and experience

• 3-5 years customer service or sales experience in a fast-paced, high-volume environment
• Proficient in Microsoft Office, Genesys, Salesforce, Pega, QNXT, CRM, Verint, Kronos, Microsoft Teams, Video Conferencing, CVS Caremark, Availity, Molina Provider Portal, and other systems as required by line of business or state

Preferred Qualifications

* Bachelor's Degree or equivalent combination of education and experience

• 5-7 years customer service or sales experience in a fast-paced, high-volume environment
• Broker/Healthcare insurance licensure

Skills and Competencies

* Excellent communication and interpersonal skills

• Ability to work in a fast-paced, dynamic environment
• Strong problem-solving and analytical skills
• Ability to work independently and as part of a team
• Proficient in multiple software systems and tools
• Strong customer service skills
• Ability to work in a remote environment

Career Growth Opportunities and Learning Benefits

* arenaflex offers a comprehensive training program to help you develop your skills and advance your career.

• Opportunities for career growth and advancement in a dynamic and growing organization.
• Access to ongoing training and development opportunities to enhance your skills and knowledge.
• Collaborative and supportive work environment that encourages teamwork and open communication.

Work Environment and Company Culture

* arenaflex is a remote-friendly organization that offers a flexible and dynamic work environment.

• Our company culture values diversity, inclusion, and teamwork, and we offer a supportive and dynamic work environment.
• Opportunities for professional growth and development in a fast-paced and dynamic industry.

Compensation, Perks, and Benefits

* Competitive salary range: $13.41 - $29.06 / HOURLY

• Comprehensive benefits package, including medical, dental, and vision insurance, 401(k) matching, and paid time off.
• Opportunities for professional growth and development in a fast-paced and dynamic industry.

How to Apply

If you are a motivated and customer-focused individual who is passionate about delivering exceptional customer experiences, we encourage you to apply for this exciting opportunity. Please submit your application through our website, and we will review your qualifications and experience. We look forward to hearing from you! Apply To This Job Apply for this job