Are you passionate about delivering exceptional customer service and making a positive impact on people's lives? Do you have a strong background in healthcare and a keen eye for detail? If so, aren'taflex is seeking an experienced Remote Healthcare Customer Service Representative to join our team in Georgia.
**About arenaflex**
arenaflex is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. We pride ourselves on being a mission-critical partner to our clients, enhancing engagement and satisfaction with their members and providers. With a strong focus on innovation and customer service, we're committed to delivering exceptional results and exceeding our clients' expectations.
**About the Role**
As a Remote Healthcare Customer Service Representative, you will play a crucial role in taking member services calls in relation to policy management, benefits, and claim inquiries. You will be a valued member of our team, providing exceptional customer service to our clients and members by ensuring their satisfaction on calls. This position requires a solid understanding of the healthcare claims, benefits, and policy process flows and expertise in healthcare terminology, including ICD-9 and ICD-10 coding.
**Key Responsibilities**
* 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**
* Handle 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.
* Authorization Management: Address and manage re-direct requests. Handle requests to re-fax authorization documents as needed.
* Extensive Claims Denial: Deep understanding and description of claims and claims denials.
* 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.
* Customer Service: Maintain a high level of professionalism and customer service in all interactions. Resolve issues promptly and effectively, ensuring customer satisfaction.
**Qualifications**
* Educational Background: High school diploma or equivalent
* Technical Skills:
+ 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.
**What We Offer**
* Genuine work/life balance - a predictable schedule
* Paid training period
* Medical, Dental, Life, Vision, HSA, 401K
* PTO
* Opportunities for career growth and professional development
* Collaborative and dynamic work environment
* Recognition and rewards for outstanding performance
**Work Environment and Company Culture**
arenaflex is committed to creating a positive and inclusive work environment that values diversity, equity, and inclusion. We believe in fostering a culture of collaboration, innovation, and continuous learning. Our team members are passionate about delivering exceptional customer service and making a positive impact on people's lives.
**Compensation and Benefits**
* Salary: $17.00 - $19.00 per hour
* Benefits: Medical, Dental, Life, Vision, HSA, 401K
* PTO: Generous paid time off policy
* Opportunities for career growth and professional development
**How to Apply**
If you're passionate about delivering exceptional customer service and making a positive impact on people's lives, we encourage you to apply for this exciting opportunity. Please submit your application through our website, and we'll be in touch to discuss your qualifications further.
**Equal Employment Opportunity**
arenaflex is an equal employment opportunity employer 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.
**Remote Work Arrangements**
This is a full-time remote position, and you will be required to work from home. You will need to have a dedicated workspace and a reliable internet connection to perform your job duties.
**Training and Onboarding**
You will receive comprehensive training and onboarding to ensure your success in this role. Our training program includes both classroom and online components, and you will be paired with a dedicated mentor to support your learning and development.
**Certifications and Licenses**
You will be required to obtain and maintain any necessary certifications and licenses to perform your job duties, including but not limited to, HIPAA certification.
**Background Check**
You will be required to undergo a background check as a condition of employment.
**Disability Accommodations**
arenaflex is committed to providing reasonable accommodations to individuals with disabilities. If you require a reasonable accommodation to perform the essential functions of this role, please notify us during the application process or upon hire.
**Confidentiality**
You will be required to sign a confidentiality agreement as a condition of employment.
**Termination**
arenaflex reserves the right to terminate your employment at any time, with or without cause.
**Governing Law**
This agreement shall be governed by and construed in accordance with the laws of the state of Georgia.
**Entire Agreement**
This agreement constitutes the entire agreement between the parties and supersedes all prior negotiations, understandings, and agreements between the parties.
**Amendments**
arenaflex reserves the right to amend this agreement at any time, with or without notice.
**Waiver**
arenaflex's failure to enforce any provision of this agreement shall not be deemed a waiver of such provision or any other provision of this agreement.
**Notices**
All notices required or permitted to be given under this agreement shall be in writing and shall be delivered personally, sent by certified mail, or sent by email.
**Headings**
The headings in this agreement are for convenience only and shall not be deemed to be a part of this agreement.
**Severability**
If any provision of this agreement is held to be invalid or unenforceable, such provision shall be deemed severable from the remainder of this agreement, and the remaining provisions shall continue in full force and effect.
**Counterparts**
This agreement may be executed in counterparts, each of which shall be deemed an original, but all of which together shall constitute one and the same agreement.
By applying for this position, you acknowledge that you have read, understand, and agree to the terms and conditions of this agreement.
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