At arenaflex, we are dedicated to providing exceptional customer service to our members and providers, and we are seeking an experienced and compassionate Customer Experience Representative III to join our team. As a Customer Experience Representative III, you will be the face of arenaflex, providing support and resolving issues for our members and providers in a fair and effective manner. If you have a passion for delivering outstanding customer service and are looking for a challenging and rewarding role, we encourage you to apply.
**About arenaflex**
arenaflex is a leading healthcare company that is committed to providing high-quality healthcare services to our members and providers. We are a dynamic and fast-paced organization that values innovation, teamwork, and customer satisfaction. Our mission is to improve the health and well-being of our members and providers, and we are seeking talented individuals who share our vision and values.
**Job Summary**
As a Customer Experience Representative III, you will be responsible for providing exceptional customer service to our members and providers, resolving issues and addressing needs fairly and effectively, and identifying opportunities to improve our member and provider experiences. You will work closely with other departments to ensure seamless communication and collaboration. This is a remote role, and you will be required to work regularly scheduled shifts within our hours of operation, including weekends and overtime as needed.
**Key Responsibilities**
* Provide service support to members and/or providers using one or more contact center communication channels, including phone, chat, email, and off-phone work, across multiple states and/or products.
* Handle escalated calls on behalf of management and provide excellent customer service for all call center communication channels.
* Accurately document all member/provider communication and maintain confidentiality.
* Ability to work regularly scheduled shifts within our hours of operation, including weekends and overtime 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.
* Achieve individual performance goals established for this position in the areas of call quality, attendance, and scheduled adherence.
* Engage and collaborate with other departments to ensure seamless communication and collaboration.
* Demonstrate 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.
* Support member needs for a wide variety of inquiries and assistance involving their benefits, claims, premiums, and other areas, including complex issues.
* Support provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing, and other areas, including complex issues.
* Proficient in three or more lines of business (for example, Medicare, Medicaid, Marketplace, MMP) for members services, provider services, and member retention.
* Respond to incoming calls from providers on a variety of issues of varying complexity, including highly complex or executive issues.
* Complete research for state, legislative, or regulatory inquiries as applicable.
* Gather information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions.
* Achieve individual performance goals as it relates to call center objectives.
* Proactively engage and collaborate with other departments as required.
* Demonstrate personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations.
* Assist with formal training needs of other employees along with new hire or training classes as needed.
* Support provider and member needs for a wide variety of inquiries involving member eligibility and covered benefits.
* Provide inquiry assistance involving claims, authorizations, appeals, contracting, credentialing, and other provider-related issues.
* Support other inquiry areas, including complex issues.
* Conduct initial research and work to immediately resolve issues.
* Appropriately escalate issues based on established risk criteria.
* Recommend and implement programs to support member needs.
* Resolve member inquiries and complaints fairly and effectively to ensure member retention.
* Respond to incoming calls from members and providers.
* Conduct 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.
* Remain 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 of customer service or sales experience in a fast-paced, high-volume environment.
* Proficient in systems utilized, including Microsoft Office, Genesys, Salesforce, Pega, QNXT, CRM, Verint, Kronos, Microsoft Teams, Video Conferencing, CVS Caremark, Availity, Molina Provider Portal, and others as required by line of business or state.
* Strong communication and interpersonal skills, with the ability to work effectively with diverse populations.
* Ability to work in a fast-paced environment, with multiple priorities and deadlines.
* Strong problem-solving and analytical skills, with the ability to think critically and creatively.
* Ability to maintain confidentiality and handle sensitive information.
**Preferred Qualifications**
* Bachelor's Degree or equivalent combination of education and experience.
* 5-7 years of customer service or sales experience in a fast-paced, high-volume environment.
* Broker/Healthcare insurance licensure.
* Experience working in a healthcare environment, with knowledge of healthcare policies and procedures.
* Experience working with electronic health records (EHRs) and other healthcare software systems.
**Work Environment and Company Culture**
arenaflex is a dynamic and fast-paced organization that values innovation, teamwork, and customer satisfaction. We are committed to providing a work environment that is inclusive, supportive, and challenging. As a Customer Experience Representative III, you will have the opportunity to work with a talented team of professionals who are passionate about delivering exceptional customer service. You will also have access to ongoing training and development opportunities, as well as a competitive benefits and compensation package.
**Compensation and Benefits**
arenaflex offers a competitive benefits and compensation package, including:
* Hourly pay rate: $13.41 - $29.06
* Overtime pay
* Paid time off (vacation, sick leave, holidays)
* Health, dental, and vision insurance
* 401(k) retirement plan
* Life insurance
* Disability insurance
* Employee assistance program (EAP)
* Professional development opportunities
**How to Apply**
If you are a motivated and customer-focused individual who is passionate about delivering exceptional customer service, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and cover letter, through our online application system. We look forward to hearing from you!
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