Experienced Remote Member Services Representative – Health Care Customer Support (Aetna Medicaid)

Join Our Compassionate Team at arenaflex

Are you passionate about making a meaningful difference in people's lives? Do you thrive in a fast-paced, customer-focused environment where your communication skills can truly shine? If so, we invite you to explore an exciting career opportunity as a Remote Member Services Representative at arenaflex.

At arenaflex, we believe that every interaction with our members is an opportunity to deliver exceptional care and support. Our commitment to human-centric health care drives everything we do, and we're looking for dedicated professionals who share our vision of transforming the health care experience for the communities we serve. As a member of our team, you'll play a vital role in ensuring that every person who contacts us receives the personalized, compassionate assistance they deserve.

About arenaflex

arenaflex is a leading health care company committed to delivering innovative solutions that make health care more personal, convenient, and affordable for all. We understand that the health care landscape is rapidly evolving, and we're dedicated to staying at the forefront of these changes by leveraging technology, expertise, and most importantly, our people. Our team members are the heart of our organization, and we take pride in fostering a culture where empowerment, collaboration, and excellence are at the core of everything we accomplish.

When you join arenaflex, you become part of a mission-driven organization that truly cares about the well-being of our members and communities. We believe that by bringing our hearts to every moment of health, we can create lasting, positive impacts on the lives of those we serve. Our Heart At Work Behaviors™ embody this philosophy, encouraging every team member to approach their role with empathy, integrity, and a relentless commitment to customer satisfaction.

Position Overview

We are currently seeking a talented and motivated Remote Member Services Representative to join our dynamic health care support team. In this role, you will be responsible for providing exceptional telephone assistance to Aetna Medicaid members and health care providers. Your primary focus will be on delivering accurate, timely, and compassionate responses to a wide range of inquiries while maintaining the highest standards of customer service.

This position is ideal for individuals who excel in verbal communication, possess strong problem-solving abilities, and enjoy working in a collaborative environment. You'll have the opportunity to interact with diverse members and providers, addressing their needs with professionalism and empathy. At arenaflex, we understand that each call represents a unique individual seeking guidance and support, and we equip our team members with the tools and training necessary to deliver outstanding experiences consistently.

Key Responsibilities

As a Member Services Representative at arenaflex, you will be entrusted with meaningful responsibilities that directly impact our members' health care experiences. Your daily duties will include:

• Telephone Support: Answering incoming calls from Aetna Medicaid members and health care providers with warmth, professionalism, and efficiency. You'll serve as the first point of contact for individuals seeking assistance, setting the tone for their entire experience with arenaflex.


• Benefits Inquiries: Responding to comprehensive questions regarding member benefits, coverage details, eligibility requirements, and program offerings. You'll need to be well-versed in explaining complex health care information in clear, understandable terms.


• Eligibility Verification: Assisting callers with eligibility verification processes, ensuring they have accurate information about their coverage and benefits. This includes troubleshooting issues and providing guidance on next steps.


• Provider Coordination: Supporting members with provider changes, network information, and connecting them with appropriate health care professionals. You'll help navigate the complexities of finding quality care within their plan.


• ID Card Requests: Processing requests for identification cards and ensuring members receive their documentation promptly. Attention to detail is crucial in this area to prevent any gaps in coverage or access to care.


• Prior Authorization Guidance: Providing information about prior authorization requirements and assisting members and providers through the authorization process. You'll help facilitate access to necessary services while maintaining compliance with policies.


• Extra Benefits and Programs: Informing members about additional benefits, wellness programs, and resources available to them through their plan. This includes preventive care services, discount programs, and community resources.


• Documentation: Maintaining accurate records of all interactions, ensuring proper documentation in our systems for quality assurance and follow-up purposes.


• Issue Resolution: Addressing concerns and complaints with empathy and efficiency, working to resolve issues during the initial contact whenever possible while escalating complex matters appropriately.

Work Environment and Schedule

This is a remote position that offers the flexibility of working from home while remaining connected to our organization. However, we require all candidates to live within 50 miles of Richmond, Virginia or New York, New York to ensure they can commute to our physical office location when necessary. Specifically, you must be prepared to travel to the office in Richmond, VA or New York, NY if you are unable to work from home due to prolonged technical problems.

Our training program is comprehensive and designed to set you up for success. The training schedule spans the first six weeks and runs from 8:30 AM to 5:00 PM EST, Monday through Friday. This intensive period will equip you with the knowledge, skills, and resources needed to excel in your role. Following training, your production schedule will also be 8:30 AM to 5:00 PM EST, Monday through Friday, providing you with a consistent and predictable work schedule.

To succeed in this remote role, you must have high-speed internet connectivity with secure service via ethernet cable. Please note that the use of Wi-Fi is not permitted for security and reliability reasons. arenaflex will provide all necessary equipment, including a computer, headset, and other materials needed to perform your job effectively. We also offer comprehensive training to ensure you feel confident and prepared to handle any situation that comes your way.

Essential Qualifications

To be considered for this position, candidates must meet the following requirements:

• Residency: Must live within 50 miles of Richmond, VA or New York, NY
• Communication Skills: Exceptional ability to communicate effectively with members and providers both orally and in written form. You must be able to convey complex information clearly and professionally.
• Self-Sufficiency: Must be capable of working independently from home and demonstrating strong self-management skills in a remote environment.
• Technical Requirements: Access to high-speed internet connectivity with secure ethernet service. Reliability and a quiet, professional workspace are essential.
• Performance Standards: Ability to meet established performance standards, including call quality goals and productivity metrics.
• Attendance: Commitment to maintaining excellent attendance and punctuality, as reliability is crucial in a customer service role.
• Education: High school diploma or equivalent required

Preferred Qualifications

While not required, the following qualifications will strengthen your application and help you excel in this role:

• Remote Call Center Experience: Previous experience working remotely in a call center setting demonstrates your ability to thrive in a virtual environment while maintaining high performance standards.


• Medicaid and Medicare Knowledge: Familiarity with Medicaid and Medicare programs, including terminology, coverage types, and member benefits, is highly valued and will accelerate your success in this role.


• Health Care Industry Background: Prior experience in health care customer service, insurance, or related fields provides a strong foundation for understanding our members' needs.


• Problem-Solving Skills: Demonstrated ability to analyze issues quickly and implement effective solutions while maintaining member satisfaction.

Compensation and Benefits

At arenaflex, we recognize that our team members are our greatest asset, and we are committed to providing competitive compensation and comprehensive benefits. The pay range for this position is $17.00 to $28.45 per hour, depending on experience, education, and qualifications. This range represents the base hourly rate for all positions within the job grade, and the actual offer will depend on various factors relevant to your background.

In addition to competitive pay, arenaflex offers a full range of benefits designed to support your health, financial security, and overall well-being:

• Health Coverage: Comprehensive medical, dental, and vision benefits for you and your family


• Retirement Savings: Eligible employees may enroll in our 401(k) retirement savings plan with company matching


• Stock Purchase Plan: Employee Stock Purchase Plan available for eligible employees


• Life Insurance: Fully-paid term life insurance plan for eligible employees


• Disability Coverage: Short-term and long-term disability benefits


• Well-Being Programs: Access to numerous well-being programs, resources, and support services


• Education Assistance: Free development courses and tuition assistance for career advancement


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


• Paid Time Off: Competitive PTO and vacation pay, along with 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. We believe in supporting our team members' work-life balance and ensuring they have the resources they need to thrive both professionally and personally.

Career Growth and Development

arenaflex is invested in the growth and development of our team members. We offer numerous opportunities for advancement and professional development, including internal promotion paths, cross-functional training, and leadership development programs. As you gain experience and demonstrate your capabilities, you'll have the chance to explore new roles and responsibilities within our organization.

We encourage continuous learning and provide access to free development courses, mentorship opportunities, and skill-building resources. Whether you're looking to advance into supervisory roles, specialize in specific areas of health care, or expand your knowledge base, arenaflex supports your career journey every step of the way.

Our Culture

When you join arenaflex, you become part of a supportive, inclusive community that values diversity and fosters collaboration. We believe that our differences make us stronger, and we're committed to creating an environment where every team member feels respected, valued, and empowered to contribute their unique perspective.

Our Heart At Work Behaviors™ guide how we interact with each other and our members. We strive to create a culture of empowerment, where everyone plays a role in transforming our organization and accelerating our ability to innovate. We celebrate achievements, support one another through challenges, and maintain a shared commitment to excellence in everything we do.

Equal Opportunity Employer

arenaflex is committed to recruiting, hiring, developing, advancing, and retaining individuals with disabilities. We provide equal access to the benefits and privileges of employment, including reasonable accommodations for qualified individuals to perform essential job functions. We encourage applicants from all backgrounds to apply and join our mission-driven team.

Join Our Team Today

If you're ready to make a meaningful difference in the lives of others while building a rewarding career with a company that truly values its people, we encourage you to apply for this exciting opportunity. At arenaflex, you'll find more than just a job – you'll find a community committed to transforming health care and improving lives.

Bring your heart to work. Apply now and become part of a team that's changing the future of health care, one conversation at a time.

Apply today and start your journey with arenaflex!