At arenaflex, we are dedicated to simplifying the health care experience and creating healthier communities. As a key member of our team, the Provider Customer Service Call and Chat Representative plays a crucial role in supporting providers who care for our members. This position involves responding to inquiries related to benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits (EOB), and behavioral health, either through phone calls or concurrent chat. The role is full-time, requiring 40 hours of work per week, Monday through Friday, with business hours from 10:30 AM to 7:05 PM CST. Occasionally, employees may need to work overtime, weekends, or holidays based on business needs. The position includes a comprehensive training program lasting 10 weeks, during which employees will work from 9:00 AM to 5:30 PM CST, Monday through Friday. Training will be conducted virtually from home, ensuring that all new hires are well-prepared to handle the responsibilities of the role. Telecommuting is available for those who reside within a 60-mile commutable distance of Houston, TX, and all telecommuters must adhere to arenaflex's Telecommuter Policy.
**About arenaflex**
arenaflex is a leading health insurance company that is committed to simplifying the health care experience and creating healthier communities. We believe in the importance of providing exceptional customer service to our providers, and we are seeking a talented and dedicated individual to join our team as a Provider Customer Service Call and Chat Representative. As a representative, you will serve as an advocate for providers, demonstrating accountability and ownership in resolving issues. You will engage with providers in a multi-channel environment, including calls and chats, and will be responsible for triaging contacts from healthcare professionals. Your ability to understand and identify the needs of providers will be essential in answering questions and resolving issues effectively.
**Responsibilities**
As a Provider Customer Service Call and Chat Representative, you will be responsible for the following key tasks:
* **Serve as an advocate for providers**: Demonstrate accountability and ownership in resolving issues, and provide exceptional customer service to our providers.
* **Service providers in a multi-channel environment**: Respond to inquiries from providers through phone calls and concurrent chat, and provide accurate and timely information to resolve issues.
* **Triage contacts from healthcare professionals**: Quickly and appropriately triage contacts from healthcare professionals, including physician offices, clinics, and billing offices.
* **Understand and identify the needs of providers**: Seek to understand the needs of providers, and answer questions and resolve issues related to benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits, and behavioral health.
* **Research and resolve complex issues**: Research and dissect complex prior authorization and claim issues, and take appropriate steps to resolve identified issues to avoid repeat calls/messages, escalations, and provider dissatisfaction.
* **Collaborate with internal partners**: Collaborate effectively with multiple internal partners to ensure issues are resolved and thoroughly communicated to providers in a timely manner.
* **Multitask and navigate multiple systems**: Strong multitasking skills are necessary to navigate more than 30 systems to extract necessary information to resolve and avoid issues across multiple lines of business (C&S, M&R, E&I) provider types, and call types.
* **Influence providers to utilize self-service digital tools**: Influence providers to utilize self-service digital tools, and assist with navigation questions and selling the benefits of the tool, including aiding in faster resolution.
**Requirements**
To be successful in this role, you will need to meet the following requirements:
* **High School Diploma / GED or equivalent work experience**: A high school diploma or equivalent work experience is required.
* **Age requirement**: You must be at least 18 years of age.
* **Customer service experience**: 1+ years of customer service experience with analyzing and solving customer's concerns is required.
* **Computer skills**: Experience with computer and Windows PC applications, including the ability to navigate and learn new and complex computer system applications.
* **Typing speed and accuracy**: Ability to type at a speed of greater than or equal to 35-40+ WPM (words per minute) with an accuracy of 90%.
* **Availability**: Ability to work any full-time (40 hours/week) shift between the hours of 10:30 AM - 7:05 PM CST from Monday - Friday. It may be necessary, given the business need, to work some occasional overtime, weekends, and/or holidays.
**Nice-to-haves**
While not required, the following skills and experiences are highly desirable:
* **Related environment experience**: Experience in a related environment (i.e., office, call center, customer service, etc.), using phones and computers as the primary job tools.
* **Prior health care experience**: Prior health care experience and knowledge of healthcare terminology.
**Benefits**
As a Provider Customer Service Call and Chat Representative at arenaflex, you will enjoy the following benefits:
* **10 weeks of paid training**: Comprehensive training program lasting 10 weeks, during which employees will work from 9:00 AM to 5:30 PM CST, Monday through Friday.
* **Flexible telecommuting options**: Flexible telecommuting options for those within a 60-mile radius of Houston, TX.
**Why join arenaflex?**
At arenaflex, we are committed to creating a work environment that is supportive, inclusive, and empowering. We believe in the importance of providing exceptional customer service to our providers, and we are seeking a talented and dedicated individual to join our team as a Provider Customer Service Call and Chat Representative. If you are passionate about delivering exceptional customer service and have a strong desire to make a difference in the lives of our providers, we encourage you to apply for this exciting opportunity.
**How to apply**
To apply for this position, please visit our website at [insert website URL]. We look forward to hearing from you!
**Equal Employment Opportunity**
arenaflex is an equal employment opportunity employer and welcomes applications from diverse candidates. We are committed to creating a work environment that is inclusive and respectful of all employees, and we believe that diversity and inclusion are essential to our success.
**Accommodation**
If you require accommodation during the application or interview process, please contact our HR department at [insert contact email or phone number]. We are committed to providing reasonable accommodations to ensure that all candidates have an equal opportunity to participate in the application and interview process.
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