At arenaflex, we're passionate about delivering exceptional customer experiences that exceed our members' and providers' expectations. As a key member of our team, you'll play a vital role in driving customer satisfaction, loyalty, and retention. If you're a customer service professional with a passion for helping others, we want to hear from you!
**About arenaflex**
arenaflex is a leading healthcare organization dedicated to providing high-quality, affordable healthcare services to our members. We're committed to making a positive impact in the lives of our members, providers, and communities. Our team is passionate about delivering exceptional customer experiences, and we're looking for talented individuals like you to join our mission.
**Job Summary**
As an Experienced Customer Experience Representative III, you'll be responsible for providing exceptional customer service to our members and providers through various communication channels, including phone, chat, email, and off-phone work. You'll be the face of arenaflex, representing our brand and values, and ensuring that our members and providers receive the highest level of service and support.
**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, including phone, chat, email, and off-phone work supporting our Medicaid, Medicare, and/or Marketplace business.
* Handle escalated calls on behalf of management, providing solutions and resolving issues in a timely and professional manner.
* Provide excellent customer service for all call center communication channels, ensuring that our members and providers receive the highest level of service and support.
* Accurately document all member/provider communication, maintaining accurate records and ensuring compliance with regulatory requirements.
* 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.
* Achieve individual performance goals established for this position in the areas of call quality, attendance, and scheduled adherence.
* Engage and collaborate with other departments, ensuring seamless communication and coordination.
* 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 very complex issues.
* Support provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing, and other areas, including the most 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 the most 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 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 of customer service or sales experience in a fast-paced, high-volume environment.
* Broker/Healthcare insurance licensure.
**What We Offer**
* Competitive salary range: $13.41 - $29.06 per hour.
* Comprehensive benefits package, including medical, dental, and vision insurance.
* 401(k) retirement plan with company match.
* Paid time off and holidays.
* Opportunities for career growth and professional development.
* Collaborative and dynamic work environment.
**How to Apply**
If you're a customer service professional with a passion for helping others, we want to hear from you! Apply today and let's build the future together.
**Equal Opportunity Employer**
arenaflex is an Equal Opportunity Employer (EOE) and welcomes applications from diverse candidates. We are committed to creating an inclusive and respectful work environment that values diversity, equity, and inclusion.