Experienced Claims Customer Service Advocate I - Part Time

Join our dynamic team at arenaflex as an Experienced Claims Customer Service Advocate I - Part Time! An immediate start is available for this Remote-based position, which places you at the center of innovation. This position requires a strong and diverse skillset in relevant areas to drive success. You can expect a salary of a competitive salary for this role, plus comprehensive benefits.

About arenaflex

arenaflex is a leading provider of innovative solutions in the insurance industry. With a rich history spanning over seven decades, we have established ourselves as a trusted partner for individuals, families, and businesses across the nation. Our commitment to delivering outstanding service, coupled with our cutting-edge technology and expertise, has enabled us to build a diverse family of subsidiary companies that cater to various business strengths.

Why Join arenaflex?

At arenaflex, we pride ourselves on being a dynamic and inclusive organization that values diversity, equity, and inclusion. We believe in fostering a culture that promotes growth, learning, and collaboration. Our team members are passionate about making a difference in the lives of our customers, and we're committed to providing a work environment that is supportive, flexible, and rewarding.

Job Summary

We are seeking an Experienced Claims Customer Service Advocate I - Part Time to join our team. As a Claims Customer Service Advocate, you will be responsible for responding to routine inquiries, identifying incorrectly processed claims, and completing adjustments and related reprocessing actions. You will also review and adjudicate claims and/or non-medical appeals, determine whether to return, deny, or pay claims, and ensure that all actions are taken in accordance with organizational policies and procedures.

Key Responsibilities

* Respond to written and/or telephone inquiries according to desk procedures, ensuring that contract standards and objectives for timeliness, productivity, and quality are met.

• Accurately document inquiries and maintain accurate records.
• Identify incorrectly processed claims and process adjustments and reprocessing actions according to department guidelines.
• Examine and process claims and/or non-medical appeals according to business/contract regulations, internal standards, and examining guidelines.
• Enter claims into the claim system after verification of correct coding of procedures and diagnosis codes.
• Ensure claims are processing according to established quality and production standards.
• Identify complaints and inquiries of a complex level that cannot be resolved following desk procedures, guidelines, and refer these to a lead or manager for resolution.
• Identify and promptly report and/or refer suspected fraudulent activities and system errors to the appropriate departments.

Qualifications

* High School Diploma or equivalent

• 1 year of experience in a claims/appeals processing, customer service, or other related support area
• Bachelor's Degree in lieu of work experience
• Good verbal and written communication skills
• Strong customer service skills
• Good spelling, punctuation, and grammar skills
• Basic business math proficiency
• Ability to handle confidential or sensitive information with discretion
• Microsoft Office

Preferred Qualifications

* Teaching or training experience

What to Expect Next

After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications. This may include a brief telephone interview or email communication with a recruiter to verify resume specifics and salary requirements. Management will be conducting interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the preferred qualifications.

Benefits and Perks

* Competitive salary

• Comprehensive benefits package
• Flexible schedule with part-time hours ranging from 20 to 38 per week
• Opportunity to work in a dynamic and inclusive organization
• Professional development and growth opportunities
• Collaborative and supportive work environment
• Recognition and rewards for outstanding performance

Equal Employment Opportunity Statement

arenaflex and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information, or any other legally protected status. We are committed to working with and providing reasonable accommodations to individuals with physical and mental disabilities. If you need special assistance or an accommodation while seeking employment, please email [email protected] or call 1-800-288-2227, ext. 47480 with the nature of your request.

Ready to Join arenaflex?

If you're a motivated and customer-focused individual who is passionate about delivering exceptional service, we want to hear from you! Apply now to join our dynamic team at arenaflex as an Experienced Claims Customer Service Advocate I - Part Time. Apply To This Job Apply for this job