Are you passionate about delivering exceptional customer experiences and making a meaningful impact in people's lives? Do you thrive in a fast-paced, dynamic environment where no two days are ever the same? If so, we invite you to join arenaflex as a Customer Care Associate I - Remote Customer Service Representative. As a key member of our team, you will play a vital role in providing top-notch support to our members and providers, ensuring their needs are met with empathy, understanding, and professionalism.
**About arenaflex**
arenaflex is a leading healthcare company dedicated to helping people get the medicine they need to feel better and live well. Our mission is to provide innovative solutions that improve the lives of our members and providers. We are passionate about delivering exceptional customer experiences, and our team is committed to making a positive impact in the healthcare industry.
**Job Summary**
As a Customer Care Associate I - Remote Customer Service Representative, you will be responsible for providing assistance to arenaflex members and providers regarding programs, policies, and procedures. You will answer incoming calls related to eligibility, benefits, claims, and authorization of services, as well as administer intake documentation into the appropriate systems. Your primary goal will be to provide outstanding service to internal and external customers, striving to resolve member and provider needs on the first call.
**Responsibilities**
* Actively listen and probe callers in a professionally and timely manner to determine the purpose of the calls.
* Research and articulately communicate information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality.
* Resolve customer administrative concerns as the first line of contact, including claim resolutions and other expressions of dissatisfaction.
* Assist efforts to continuously improve by assuming responsibility for identifying and bringing to the attention of responsible entities operations problems and/or inefficiencies.
* Assist in the mentoring and training of new staff.
* Assume full responsibility for self-development and career progression, proactively seeking and participating in ongoing training sessions (formal and informal).
* Comprehensively assemble and enter patient information into the appropriate delivery system to initiate the EAP, Care, and Utilization management programs.
* Demonstrate flexibility in areas such as job duties and schedule to aid in better serving members and help arenaflex achieve its business and operational goals.
* Educate providers on how to submit claims and when/where to submit a treatment plan.
* Identify and respond to Crisis calls and continue assistance with the Clinician until the call has been resolved.
* Inform providers and members on arenaflex's appeal process.
* Lead or participate in activities as requested that help improve Care Center performance, excellence, and culture.
* Link or make routine referrals and triage decisions not requiring clinical judgment.
* Perform necessary follow-up tasks to ensure member or provider needs are completely met.
* Provide information regarding arenaflex's in-network and out-of-network reimbursement rates and states multiple networks to providers.
* Refer callers requesting provider information to Provider Services regarding arenaflex's professional provider selection criteria and application process.
* Refer patients/EAP clients to the arenaflex's Care Management team for a provider, EAP affiliate, or Facility.
* Responsible for updating self on ever-changing information to ensure accuracy when dealing with members and providers.
* Support team members and participate in team activities to help build a high-performance team.
* Thoroughly document customers' comments/information and forward required information to the appropriate staff.
**Requirements**
* Must be flexible in scheduling and comfortable with change as customer service is an ever-changing environment.
* Responsible for meeting call handling requirements and daily telephone standards as set forth by management.
* Must agree to observing service for the purpose of training and quality control.
* Must be a proficient typist (avg. 35+ WPM) with strong written and verbal communication skills.
* Must be able to maneuver through various computer platforms while verifying information on all calls.
* Must be able to talk and type simultaneously.
**Work Experience**
* Work Experience - Required: Customer Service
* Work Experience - Preferred: 1-2 years of customer service experience
* Education - Required: GED, High School Education
* Education - Preferred: Associates, Bachelors
* Certifications - Required: None
* Certifications - Preferred: None
**Compensation and Benefits**
* Potential pay for this position ranges from $16.00 - $21.26 based on experience and skills.
* Pay range may vary by 8% depending on applicant location.
* arenaflex offers a comprehensive benefits package, including medical, dental, and vision insurance, 401(k) matching, and paid time off.
* arenaflex is an equal opportunity and affirmative action employer, committed to diversity and inclusion.
**Why Join arenaflex?**
* arenaflex is a dynamic and growing company with a passion for innovation and customer satisfaction.
* Our team is dedicated to making a positive impact in the healthcare industry.
* We offer a comprehensive benefits package and opportunities for career growth and development.
* arenaflex is a Tobacco-Free Workplace employer, committed to promoting a healthy and safe work environment.
**How to Apply**
If you are a motivated and customer-focused individual who is passionate about delivering exceptional service, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, to [insert contact information]. We look forward to hearing from you and exploring how you can contribute to our team's success.