**Experienced Customer Service Representative – Work From Home – arenaflex**

At arenaflex, we're committed to delivering exceptional care to our customers, and we're looking for talented individuals to join our team as Customer Service Representatives. As a Customer Service Representative, you'll play a vital role in providing top-notch support to our customers, answering their questions, resolving their issues, and exceeding their expectations. **About arenaflex** arenaflex is a leading healthcare company that's dedicated to transforming the way healthcare is delivered. Our purpose is to bring our heart to every moment of our customers' health, and we're passionate about making a positive impact on people's lives. With a focus on innovation, convenience, and affordability, we're committed to delivering exceptional care to our customers. **Our Heart At Work Behaviors** At arenaflex, we believe that our Heart At Work Behaviors are essential to delivering exceptional care to our customers. These behaviors include: * Empathy: We put ourselves in our customers' shoes and understand their needs and concerns. * Accountability: We take ownership of our actions and decisions, and we're accountable for the outcomes. * Collaboration: We work together as a team to achieve our goals and deliver exceptional care. * Innovation: We're always looking for new and better ways to deliver care to our customers. * Respect: We treat our customers, colleagues, and partners with respect and dignity. **Job Summary** As a Customer Service Representative, you'll be responsible for providing exceptional support to our customers, answering their questions, resolving their issues, and exceeding their expectations. You'll work from home, and you'll be required to attend 4 weeks of training (virtual) between the hours of 8-5 EST. After training, your permanent schedule will be Monday-Friday, and you can start as early as 8 am EST and end as late as 7 pm EST. **Key Responsibilities** * Answer questions and resolve issues based on phone calls/letters from members, providers, and plan sponsors. * Triages resulting rework to appropriate staff. * Provide excellent customer service for high-volume inbound provider calls for the Claims Inquiry/Claims Research team. * Extensive claims research on multiple platforms to assist providers with payment questions. * Provides the customer with related information to answer the unasked questions, e.g., additional plan details, benefit plan details, member self-service tools, etc. * Uses customer service threshold framework to make financial decisions to resolve member issues. * Explains member's rights and responsibilities in accordance with contract. * Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance, and appeals (member/provider) via target system. * Educates and assists providers on our self-service options. * Assists providers with credentialing and re-credentialing and contracting questions and issues. * Assists in compiling claim data for customer audits. * Determines medical necessity, applicable coverage provisions, and verifies member plan eligibility relating to incoming correspondence and internal referrals. **Required Qualifications** * MUST live in the state of Florida full-time. * Familiarity with Microsoft Office products. * Experience in highly transactional call center environment. * Excellent customer service and critical thinking. * High-speed internet access (25 mbps or higher) and consistent connection. * Work location must be set up with a direct connection to the router (NOT Wi-Fi). We provide a 6 ½ foot long ethernet cord, if the distance is further, you will be required to provide your own ethernet cable. **Education** * High School diploma or GED equivalent. **Skills and Competencies** * Excellent communication and interpersonal skills. * Ability to work in a fast-paced environment and prioritize tasks effectively. * Strong problem-solving and critical thinking skills. * Ability to work independently and as part of a team. * Strong customer service skills and a passion for delivering exceptional care. **Career Growth Opportunities and Learning Benefits** At arenaflex, we're committed to helping our employees grow and develop their careers. We offer a range of training and development programs, including: * On-the-job training and coaching. * Online training and development courses. * Mentorship programs. * Leadership development programs. **Work Environment and Company Culture** At arenaflex, we're committed to creating a positive and inclusive work environment. We believe that our employees are our greatest asset, and we're passionate about supporting their well-being and success. Our company culture is built on our Heart At Work Behaviors, and we're committed to delivering exceptional care to our customers. **Compensation, Perks, and Benefits** At arenaflex, we're committed to offering our employees a competitive compensation package, including: * A base hourly rate or base annual full-time salary. * Opportunities for career growth and advancement. * A range of benefits, including medical, dental, and vision benefits. * A 401(k) retirement savings plan. * An Employee Stock Purchase Plan. * Paid Time Off (PTO) or vacation pay. * Paid holidays throughout the calendar year. * Number of paid holidays, sick time, and other time off are provided consistent with relevant state law and Company policies. **How to Apply** If you're passionate about delivering exceptional care to our customers and you're looking for a challenging and rewarding career opportunity, we'd love to hear from you. Apply now to join our team as a Customer Service Representative! Apply! 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