Experienced Customer Service Representative – Provider Support and Advocacy

At arenaflex, we are dedicated to simplifying the health care experience and creating healthier communities. As a key member of our team, the Provider Customer Service Call and Chat Representative plays a vital role in supporting providers who care for our members. This position involves responding to inquiries related to benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits (EOB), and behavioral health, either through phone calls or concurrent chat. The role is full-time, requiring 40 hours per week from Monday to Friday, with flexibility to work any of our 8-hour shift schedules during normal business hours of 10:35 AM to 7:05 PM CST. Given the business needs, occasional overtime, weekends, and holidays may be required.

About arenaflex

arenaflex is a leading health care organization that is committed to making a positive impact on the lives of our members and the communities we serve. We believe in the importance of providing exceptional customer service and creating a supportive environment for our providers. Our team is passionate about delivering high-quality care and making a difference in the world.

Job Summary

As a Provider Customer Service Call and Chat Representative, you will serve as an advocate for providers, demonstrating accountability and ownership in resolving issues. You will engage with providers in a multi-channel environment, including calls and chats, and will be responsible for triaging contacts from healthcare professionals, understanding their needs, and providing timely resolutions to their inquiries. In this role, you will research and dissect complex prior authorization and claim issues, collaborating with multiple internal partners to ensure effective communication and resolution.

Responsibilities

* Serve as the advocate for providers by demonstrating accountability and ownership to resolve issues.

• Service providers in a multi-channel environment including call and concurrent chat as required.
• Quickly and appropriately triage contacts from healthcare professionals (i.e., physician offices, clinics, billing offices).
• Seek to understand and identify the needs of the provider, answering questions and resolving issues (e.g., benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits, behavioral health).
• Research and dissect complex prior authorization and claim issues and take appropriate steps to resolve identified issues to avoid repeat calls/messages, escalations, and provider dissatisfaction.
• Collaborate effectively with multiple internal partners to ensure issues are resolved and thoroughly communicated to providers in a timely manner.
• Strong multitasking to effectively and efficiently navigate more than 30 systems to extract necessary information to resolve and avoid issues across multiple lines of business (C&S, M&R, E&I) provider types, and call types.
• Influence providers to utilize self-service digital tools assisting with navigation questions and selling the benefits of the tool including aiding in faster resolution.

Requirements

* High School Diploma / GED OR equivalent work experience.

• 1+ years of customer service experience with analyzing and solving customer's concerns.
• Experience with computer and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications.
• Ability to type at the speed of greater than or equal to 35 - 40+ WPM with an accuracy of 90%.
• Must be 18 years of age or older.
• Ability to work any full-time (40 hours/week), 8-hour shift between the hours of 10:35 AM - 7:05 PM CST from Monday - Friday.

Nice-to-haves

* Prior health care experience and knowledge of healthcare terminology.

• Experience in a related environment (i.e., office, call center, customer service, etc.), using phones and computers as the primary job tools.

Benefits

* Comprehensive benefits package

• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

Training and Development

* 12 weeks of paid training, conducted virtually from home, with training hours set from 8:00 AM to 4:30 PM CST, Monday through Friday.

• Opportunities for professional development and growth within the organization.

Work Environment and Culture

* arenaflex is a remote-friendly organization, offering flexible work arrangements to support work-life balance.

• Collaborative and supportive team environment.
• Opportunities for professional growth and development.

How to Apply

If you are a motivated and customer-focused individual who is passionate about delivering exceptional service, we encourage you to apply for this exciting opportunity. Please submit your application through our website, and we will be in touch to discuss your qualifications further. Apply Now! Apply for this job