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

At arenaflex, we're dedicated to revolutionizing the healthcare industry by providing exceptional customer experiences that make a meaningful difference in people's lives. As a customer service representative, you'll play a vital role in delivering our mission by managing customer inquiries, resolving complaints, and providing top-notch support to our valued clients. **About arenaflex** arenaflex is a leading healthcare organization that's passionate about transforming the way we deliver care. Our purpose is to bring our heart to every moment of your health, and we're committed to making healthcare more personal, convenient, and affordable. With a strong focus on innovation and customer-centricity, we're constantly pushing the boundaries of what's possible in healthcare. **Our Heart At Work Behaviors** At arenaflex, we believe that everyone who works with us should feel empowered to make a difference. Our Heart At Work Behaviors support this purpose by encouraging collaboration, innovation, and a commitment to excellence. We're looking for talented individuals who share our passion for delivering exceptional customer experiences and are eager to join a dynamic team that's shaping the future of healthcare. **Job Summary** As an experienced customer service representative, you'll be responsible for managing customer inquiries, resolving complaints, and providing top-notch support to our valued clients. You'll work from home, using your excellent communication skills and technical expertise to deliver exceptional customer experiences that meet our high standards. **Responsibilities** * Maintain a positive, empathetic, and professional attitude toward customers at all times * Respond promptly to customer inquiries and resolve complaints in a timely and efficient manner * Communicate with customers through various channels, including phone, email, and chat * Process orders, forms, applications, and requests with accuracy and attention to detail * Keep records of customer interactions, transactions, comments, and complaints * Communicate and coordinate with colleagues as necessary to ensure seamless customer service * Provide feedback on the efficiency of the customer service process and suggest improvements * Manage a team of junior customer service representatives (in the future) **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 services 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 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 & 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 **Requirements** * Must live in the state of Oklahoma 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 **Work Schedule** * This position is work from home and you must live in the State of Oklahoma. * Must be able to attend 4 weeks of training (virtual) between the hours of 8-5 CST. * After training, the permanent schedule is an Monday-Friday and can start as early as 7 am CST and end as late as 7 pm CST. **What We Offer** * Competitive salary and benefits package * Opportunities for career growth and professional development * Collaborative and dynamic work environment * Recognition and rewards for outstanding performance * Comprehensive training and support to ensure your success **How to Apply** If you're a motivated and customer-focused individual who is passionate about delivering exceptional experiences, 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. Apply Job! Apply for this job