Experienced Customer Service Representative – Work From Home | Claims Inquiry & Provider Support Specialist

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Join arenaflex as a Remote Customer Service Representative

Are you ready to make a meaningful impact in healthcare without leaving the comfort of your home? arenaflex is seeking a dedicated and compassionate Customer Service Representative to join our dynamic Claims Inquiry and Provider Support team. In this fully remote role, you'll be the voice of arenaflex, helping healthcare providers navigate their payment questions, resolving complex claims issues, and delivering exceptional service that keeps our healthcare ecosystem running smoothly.

At arenaflex, we believe that great customer service is the backbone of quality healthcare. As a member of our team, you'll play a pivotal role in ensuring that healthcare providers receive the support they need to focus on what matters most—caring for patients. This is an excellent opportunity for individuals who are looking to start a rewarding career in healthcare customer service, with comprehensive training provided and no prior experience required.

What You'll Do

As a Customer Service Representative at arenaflex, you'll be responsible for handling high-volume inbound calls from healthcare providers, plan sponsors, and members. Your primary objective will be to answer questions, resolve issues, and ensure every caller receives prompt, accurate, and friendly assistance. This role requires someone who thrives in a fast-paced environment and can multitask effectively while maintaining exceptional attention to detail.

Key Responsibilities Include:

• Handle Inbound inquiries: Answer questions and resolve issues based on phone calls, letters, and electronic communications from members, providers, and plan sponsors. Triage resulting rework to appropriate staff members when necessary.


• Claims Research: Conduct extensive research on multiple platforms to assist providers with payment questions, including investigating claim status, identifying discrepancies, and explaining reimbursement processes.


• Financial Decision-Making: Use our customer service threshold framework to make financial decisions that resolve member issues, ensuring fair and accurate outcomes within established guidelines.


• Provide Comprehensive Information: Offer related information to answer unasked questions, such as additional plan details, benefit plan information, and member self-service tools available through our digital platforms.


• Process Referrals and Complaints: Handle claim referrals, new claim handoffs, nurse reviews, complaints (both member and provider), grievances, and appeals through our target system, ensuring all documentation is accurate and complete.


• Provider Education: Educate providers on claim submission processes, coverage provisions, and proper documentation requirements to reduce future errors and improve overall efficiency.


• Audit Support: Assist in compiling claim data for customer audits, maintaining meticulous records and ensuring compliance with regulatory standards.


• Eligibility Verification: Determine medical necessity, applicable coverage provisions, and verify member plan eligibility relating to incoming correspondence and internal referrals.

What We're Looking For

We welcome individuals who are passionate about helping others and are committed to delivering outstanding customer service. While prior experience in healthcare customer service is a plus, it's not required—we provide comprehensive training to set you up for success. What matters most is your dedication, your problem-solving abilities, and your commitment to representing arenaflex with professionalism and empathy.

Required Qualifications:

• Residency: Must live in the state of Florida full-time. This is a non-negotiable requirement due to regulatory and licensing considerations.
• Technical Skills: Familiarity with Microsoft Office products (Word, Excel, Outlook) is essential for documenting interactions and managing information.
• Call Center Experience: Experience in a highly transactional call center environment is required. You should be comfortable handling high-volume calls and managing multiple tasks simultaneously.
• Customer Service Skills: Excellent customer service and critical thinking abilities are a must. You should be able to listen actively, empathize with callers, and find effective solutions to complex problems.
• Internet Requirements: High-speed internet access (25 Mbps or higher) with a consistent, reliable connection. Your work location must be set up with a direct ethernet connection to the router (NOT Wi-Fi). We provide a 6½-foot ethernet cord; if your setup requires a longer cable, you will need to provide your own.
• Education: High School diploma or GED equivalent is required.

Preferred Qualifications:

• Previous experience in healthcare, insurance, or claims processing


• Knowledge of medical terminology and billing procedures


• Familiarity with HMO, PPO, or other health plan structures


• Strong typing speed and data entry accuracy


• Experience with CRM systems and ticketing platforms

Why arenaflex?

At arenaflex, we understand that our employees are our greatest asset. That's why we're committed to providing a comprehensive benefits package that supports your health, financial security, and work-life balance. When you join our team, you become part of a organization that puts its heart into caring for our colleagues and our communities.

Compensation:

The typical pay range for this role is $25.00 - $38.00 per hour. This pay range represents the base hourly rate for all positions within the job grade, and the actual offer will depend on a variety of factors including experience, education, geography, and other relevant factors. We also offer opportunities for overtime and performance-based bonuses.

Benefits Package:

• Health Insurance: Enjoy a full range of medical, dental, and vision benefits. Eligible employees may enroll in our comprehensive health plans, with coverage beginning on your first day of employment.


• Retirement Savings: Eligible employees may participate in our 401(k) retirement savings plan, with company matching contributions to help you save for the future.


• Stock Purchase Plan: An Employee Stock Purchase Plan is also available for eligible employees, allowing you to invest in arenaflex's continued growth.


• Life Insurance: The Company provides a fully-paid term life insurance plan to eligible employees, along with short-term and long-term disability benefits for added peace of mind.


• Wellbeing Programs: Take advantage of numerous well-being programs designed to support your physical, mental, and emotional health.


• Education Assistance: We offer free development courses and educational assistance to help you grow both personally and professionally.


• Employee Discounts: Enjoy a arenaflex store discount and discount programs with participating partners.


• Time Off: We believe in the importance of rest and rejuvenation. Enjoy Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year. The number of paid holidays, sick time, and other time off are provided consistent with relevant state laws and Company policies.

Work Environment

This is a fully remote position, meaning you can work from the comfort of your Florida home. We provide all the necessary training and support to ensure you have everything you need to succeed. You'll need to create a dedicated workspace that meets our technical requirements, including a reliable ethernet connection to our network.

Our remote culture is built on trust, communication, and collaboration. You'll have access to our digital collaboration tools, regular team meetings, and ongoing support from your manager and colleagues. While you're working independently, you'll never feel alone—we're all here to help you thrive.

Career Growth Opportunities

At arenaflex, we invest in our employees' futures. This role is an excellent entry point into the healthcare industry, and there are numerous opportunities for advancement. As you gain experience and demonstrate your capabilities, you may progress into roles such as:

• Senior Customer Service Representative


• Team Lead or Supervisor


• Claims Analyst or Specialist


• Quality Assurance Coordinator


• Training and Development roles

We also encourage continuous learning and provide access to free development courses, certification programs, and tuition assistance for eligible employees. Your career path at arenaflex is what you make of it—and we're here to support your goals.

Ready to Make a Difference?

If you're ready to join a team that values compassion, excellence, and integrity, we encourage you to apply for this exciting opportunity. As a Customer Service Representative at arenaflex, you'll not only build a fulfilling career but also make a real difference in the lives of healthcare providers and the patients they serve.

We are committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. As such, we strive to provide equal access to the benefits and privileges of employment, including the provision of a reasonable accommodation to perform essential job functions. If you need a reasonable accommodation, including a qualified interpreter, written information in other formats, translation, or other services, please reach out to our HR team.

Apply today and take the first step toward a rewarding career with arenaflex! We can't wait to welcome you to our team.