**Experienced Customer Service Representative - National Remote**

At arenaflex, we're simplifying the health care experience, creating healthier communities, and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable, and equitable. Ready to make a difference? Join us and start doing your life's best work.

• *About arenaflex**

arenaflex is a leading health care company that's dedicated to helping people live healthier lives and making the health system work better for everyone. We believe everyone – of every race, gender, sexuality, age, location, and income – deserves the opportunity to live their healthiest life. Our mission is to help people live healthier lives and make the health system work better for everyone.

• *About the Role**

As an Experienced Customer Service Representative at arenaflex, you'll play a critical role in creating a quality experience for our members and providers. You'll be responsible for providing accurate, professional, personalized, and compassionate help, guidance, and support to our customers. You'll spend the majority of your day responding to calls from our members and helping answer questions and resolve issues regarding health care eligibility, claims, and payments. You'll also spend a portion of your time reviewing, researching, and processing healthcare claims to ensure that every claim has a fair and thorough review.

• *Key Responsibilities**

• Address and resolve customer service calls empathetically and professionally
• Accurately document, research, and resolve all inquiries, ensuring documentation is clear and complete
• Respond and resolve inquiries on the first call by identifying the topic and type of assistance the caller needs (benefits, eligibility, material requests, physician assignments, claims, billing, and payment, etc.) utilizing all resources available
• Monitor and expeditiously close any inquiries which require follow-up based on departmental guidelines
• Refer unresolved inquiries/Grievances to designated areas for investigation
• Own problem through resolution on behalf of the caller in real-time or through comprehensive and timely follow-up with support resources/partner with others to resolve complex issues
• Intervene with care providers (doctor's offices) on behalf of participants (assist with appointment scheduling, access to care issues, etc.)
• Assist providers with all levels of requests, ability to problem-solve through resolution
• Coordinate with field Care Team staff for issue elevation and resolution
• Maintain up-to-date knowledge and understanding of claims policies, regulatory requirements, and guidelines
• Successfully utilize all resources available to handle inquiries/multitask
• Meet or exceed individual and departmental quality standards/achieve performance goals
• Adhere, keep updated, and utilize all company guidelines, policies, and procedures
• Prioritize and adjust individual workload to ensure departmental goals are met
• Assume responsibility for ad-hoc projects or functions that promote the future success of the operation

• *Essential Qualifications**

• High School Diploma / GED OR 10+ years of equivalent working experience
• 2+ years Customer Service experience
• Must be 18 years of age or older
• Ability to type a minimum of 40 words per minute
• Ability to work two evening shifts per week (typically 11am-8pm EST)
• Ability to work three Holidays not observed by Client (Day after Thanksgiving, Christmas Eve, New Year's Day)
• Ability to successfully complete the Customer Service training classes and demonstrate proficiency of the material
• Ability to work any of our 8-hour shift schedules during our normal business hours of 8:00am - 8:00pm CST. It may be necessary, given the business need, to work occasional overtime.

• *Preferred Qualifications**

• 1+ years prior experience in an automatic call distribution call center setting
• Knowledge of CPT/ICD10 coding
• Knowledge of Medicare/Medicaid guidelines

• *Telecommuting Requirements**

• Ability to keep all company-sensitive documents secure (if applicable)
• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
• Must live in a location that can receive a UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service.

• *Soft Skills**

• Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manner, consistently meeting commitments)
• Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests, and identify the current and future needs of the member
• Proficient problem-solving approach to quickly assess current state and formulate recommendations
• Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon
• Flexibility to customize approach to meet all types of member communication styles and personalities
• Proficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrating personal resilience
• Ability to work regularly scheduled shifts within our hours of operation, including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and/or weekends, as needed

• *Compensation and Benefits**

• California, Colorado, Connecticut, Nevada, New Jersey, New York, Washington, or Rhode Island Residents Only: The hourly range for California / Colorado / Connecticut / Nevada / New York / New Jersey / Washington / Rhode Island residents is $16.00 - $27.31 per hour. Pay is based on several factors, including but not limited to education, work experience, certifications, etc.
• In addition to your salary, arenaflex offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements).

• *Diversity and Inclusion**

• arenaflex is an Equal Employment Opportunity / Affirmative Action employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
• arenaflex is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

• *How to Apply**

If you're passionate about making a difference in people's lives and want to join a team that's dedicated to simplifying the health care experience, creating healthier communities, and removing barriers to quality care, apply now!