Medical Claims Customer Service Representative – Remote, Full‑Time, Healthcare Claims Support Specialist (WFH)

About arenaflex – Pioneering Value‑Based Healthcare

arenaflex is a data‑driven, performance‑focused healthcare organization that is reshaping the way patients, providers, and insurers interact. Our mission is simple yet ambitious: make high‑quality healthcare affordable, improve patient outcomes, and restore the joy of practicing medicine for clinicians. By blending empathy with cutting‑edge artificial intelligence and predictive analytics, arenaflex delivers a seamless, remote “Healthguides™” experience and operates a centralized Managed Service Organization that bridges the gap between patients and providers. Our physician‑led team empowers partners to deliver exceptional care while prioritizing outcomes, value, and satisfaction for every stakeholder.

Why This Role Matters at arenaflex

As a Medical Claims Customer Service Representative, you will be the frontline voice of arenaflex, ensuring that our members and client partners receive timely, accurate, and compassionate support. Your work directly influences claim resolution speed, member satisfaction, and the overall efficiency of our value‑based care model. If you thrive in a fast‑paced, high‑volume environment and are passionate about making a tangible difference in the healthcare ecosystem, this remote position offers the perfect blend of purpose and professional growth.

Key Responsibilities – What You’ll Do Every Day

• Answer inbound client and member calls with precision, empathy, and a commitment to follow‑through.
• Provide outstanding customer service that reflects arenaflex’s standards of professionalism and care.
• Address inquiries related to claims payment status, coverage details, and procedural questions.
• Interpret and apply client health‑plan protocols, ensuring compliance with regulatory and contractual obligations.
• Assist with claims processing tasks, including generating reports, managing workflow queues, and updating claim statuses.
• Document each interaction accurately in the CRM system, maintaining a high level of data integrity.
• Return missed calls promptly and manage additional duties such as mailing assistance, data entry, and ad‑hoc projects as assigned.
• Collaborate with cross‑functional teams—including underwriting, billing, and provider relations—to resolve complex issues.
• Continuously identify opportunities for process improvement and share insights with leadership.

Essential Qualifications – What We Require

• 1–3 years of customer service experience within the healthcare sector.
• Demonstrated knowledge of healthcare claims processing and familiarity with claim‑related terminology.
• Experience working in a high‑volume call‑center environment, handling multiple calls and tasks simultaneously.
• Background in health insurance or a related healthcare field is strongly preferred.
• Familiarity with arenaflex HMOI or comparable insurance plans (e.g., Medicare Advantage) is a plus.
• Proficiency with Microsoft Office Suite (Word, Excel, Outlook) and the ability to quickly learn multiple internal systems.
• Excellent verbal and written communication skills, with a clear, courteous, and professional phone demeanor.
• Availability to work an 8‑hour shift between 8 AM and 6 PM Central Time, Monday through Friday.

Preferred Qualifications – What Would Set You Apart

• Direct experience with HMO Managed Care plans and Medicare Advantage programs.
• Certification or training in medical billing, coding (CPT, HCPCS), or health information management.
• Previous exposure to AI‑driven claim adjudication tools or predictive analytics platforms.
• Demonstrated ability to handle escalations and resolve complex claim disputes independently.
• Strong analytical mindset with a track record of identifying trends and recommending actionable solutions.

Core Skills & Competencies

• Customer‑Centric Mindset: Ability to place the member’s needs at the forefront while balancing organizational policies.
• Attention to Detail: Accurate documentation and meticulous handling of claim data.
• Problem‑Solving: Quick identification of root causes and effective resolution of claim‑related issues.
• Technical Agility: Comfort navigating multiple software platforms, databases, and CRM tools.
• Team Collaboration: Strong interpersonal skills for working with internal teams and external partners.
• Time Management: Ability to prioritize tasks, meet SLAs, and maintain productivity in a remote setting.

Career Growth & Learning Opportunities

arenaflex invests heavily in the professional development of its employees. As a member of our claims support team, you will have access to:

• Structured onboarding and continuous training programs covering claims adjudication, compliance, and advanced customer service techniques.
• Mentorship from seasoned healthcare professionals and physician leaders.
• Opportunities to cross‑train in related departments such as provider relations, underwriting, and analytics.
• Tuition reimbursement and certification support for industry‑recognized credentials (e.g., Certified Professional Biller, Certified Claims Analyst).
• Clear career pathways leading to senior specialist, team lead, or operations manager roles within arenaflex’s expanding network.

Work Environment & Culture at arenaflex

Our remote workforce is built on trust, flexibility, and a shared commitment to excellence. arenaflex fosters a culture where:

• Innovation is encouraged—employees are invited to share ideas that improve processes and member experiences.
• Inclusivity is a core value—diverse perspectives are celebrated, and every voice is heard.
• Work‑life balance is respected—flexible scheduling, generous PTO, and a supportive leadership team help you thrive both professionally and personally.
• Collaboration thrives through virtual huddles, regular team check‑ins, and a robust internal communication platform.
• Recognition is frequent—high performers receive awards, bonuses, and public acknowledgment.

Compensation, Perks & Benefits

arenaflex offers a competitive compensation package that reflects your experience and expertise. While the base hourly rate ranges from $18.45 to $20.50, final pay is determined by skill set, relevant experience, education, location, and certifications.

• Remote Work Flexibility: Fully remote position eliminates commute and allows you to create a personalized home office.
• Comprehensive Health Coverage: Medical, dental, and vision plans for you and your family.
• Retirement Savings: 401(k) with a 3% employer match on your 6% contribution.
• Life & Disability Insurance: Core coverage with optional supplemental plans.
• Employee Assistance Program (EAP): Confidential counseling and support services.
• Flexible Paid Time Off (PTO): Tailored to help you maintain a healthy work‑life balance.
• Paid Parental Leave: Generous time off for new parents.
• Professional Development: Access to learning platforms, webinars, and industry conferences.
• Performance Bonuses: Incentives tied to quality metrics and claim resolution efficiency.

Equal Opportunity & Inclusion

arenaflex is committed to building a diverse, inclusive, and equitable workplace. We make employment decisions without regard to race, religion, color, age, sex, sexual orientation, gender identity, national origin, citizenship, marital status, familial status, disability, military or veteran status, pregnancy, or any other protected characteristic. Our goal is to ensure every employee feels valued, respected, and empowered to succeed.

Security & Compliance Commitment

In this role, you will adhere to strict security policies and procedures designed to protect protected health information (PHI) and intellectual property. Specific responsibilities for security compliance will be outlined by your hiring manager, and ongoing training will be provided to keep you up‑to‑date with industry standards and regulatory requirements.

How to Apply

If you are ready to join a forward‑thinking organization that blends technology with compassionate care, we want to hear from you. Click the link below to submit your application and start your journey with arenaflex today.

Apply Job!

Take the Next Step

At arenaflex, your contributions directly impact the health and well‑being of millions of individuals. Join us, grow your career, and help shape the future of value‑based healthcare.