Are you a people person with a passion for delivering exceptional customer experiences? Do you thrive in a fast-paced, dynamic environment where no two interactions are ever the same? If so, we want to hear from you! arenaflex is urgently hiring for a Customer Service Representative – Work From Home position, and we're looking for talented individuals like you to join our team.
**About arenaflex**
At arenaflex, we're committed to revolutionizing the way we deliver healthcare services. Our purpose is simple: to bring our heart to every moment of your health. We believe that how we deliver our services is just as important as what we deliver, and we're dedicated to creating a culture that's centered around empathy, compassion, and innovation.
**Our Heart At Work Behaviors**
Our Heart At Work Behaviors support our purpose and guide our actions every day. They include:
* **Empathy**: We put ourselves in our customers' shoes and understand their needs.
* **Compassion**: We show kindness and care in every interaction.
* **Innovation**: We're always looking for new and better ways to deliver our services.
* **Collaboration**: We work together as a team to achieve our goals.
* **Accountability**: We take ownership of our actions and results.
**This Position is Work From Home and You Must Live in the State of Florida**
As a Customer Service Representative – Work From Home, you'll be working from the comfort of your own home, serving customers in the State of Florida. You'll be responsible for answering questions, resolving issues, and providing excellent customer service to our members, providers, and plan sponsors.
**Must Be Able to Attend 4 Weeks of Training (Virtual) Between the Hours of 8-5 EST**
Before you start working from home, you'll need to attend 4 weeks of virtual training between the hours of 8-5 EST. This will give you the skills and knowledge you need to succeed in this role.
**After Training, the Permanent Schedule is an Monday-Friday and Can Start as Early as 8 am EST and End as Late as 7 pm EST**
After your training, you'll work a Monday-Friday schedule, with the flexibility to start as early as 8 am EST and end as late as 7 pm EST.
**Key Responsibilities:**
* Answer questions and resolve issues based on phone calls/letters from members, providers, and plan sponsors.
* Triages resulting rework to appropriate staff.
* Provide excellent customer services for high volume in-bound provider calls for the Claims Inquiry/Claims Research team.
* Extensive claims research on multiple platforms to assist providers with payment questions.
* Provides the customer with related information to answer the unasked questions, e.g. additional plan details, benefit plan details, member self-service tools, etc.
* Uses customer service threshold framework to make financial decisions to resolve member issues.
* Explains member's rights and responsibilities in accordance with contract.
* Processes claim referrals, new claim handoffs, nurse reviews, complaints (member/provider), grievance and appeals (member/provider) via target system.
* Educates & assists providers on our self-service options.
* Assists providers with credentialing and re-credentialing and contracting questions and issues.
* Assists in compiling claim data for customer audits.
* Determines medical necessity, applicable coverage provisions and verifies member plan eligibility relating to incoming correspondence and internal referrals.
**Required Qualifications:**
* MUST live in the state of Florida full-time.
* Familiarity with Microsoft Office products.
* Experience in highly transactional call center environment.
* Excellent customer service and critical thinking.
* High speed internet access (25 mbps or higher) and consistent connection.
* Work location must be set up with a direct connection to the router (NOT Wi-Fi). We provide a 6 ½ foot long ethernet cord, if the distance is further, you will be required to provide your own ethernet cable.
**Education:**
* High School diploma or GED equivalent.
**Pay Range:**
* The typical pay range for this role is: $17.00 – $25.15.
* This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls.
* The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.
**Benefits:**
* Enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities.
* The Company offers a full range of medical, dental, and vision benefits.
* Eligible employees may enroll in the Company’s 401(k) retirement savings plan, and an Employee Stock Purchase Plan is also available for eligible employees.
* The Company provides a fully-paid term life insurance plan to eligible employees, and short-term and long term disability benefits.
* CVS Health also offers numerous well-being programs, education assistance, free development courses, a CVS store discount, and discount programs with participating partners.
* As for time off, Company employees enjoy Paid Time Off (“PTO”) or vacation pay, as well as paid holidays throughout the calendar year.
**We Want to Hear From You!**
If this role sounds like a perfect fit, don't hesitate. Apply today and let's build the future together.