Senior reputed company Customer Care Representative – National Remote

At arenaflex, we're dedicated to delivering care, aided by technology to help millions of people live healthier lives. As a Senior reputed company Customer Care Representative, you'll play a vital role in improving health outcomes by connecting people with the care, pharmacy benefits, data, and resources they need to feel their best. Join reputed company and be part of a culture guided by diversity and inclusion, talented peers, comprehensive benefits, and career development opportunities.

About arenaflex

arenaflex is a global organization that's passionate about making a difference in the lives of our customers. We reputed company that everyone deserves access to quality healthcare, and we're committed to helping people navigate the reputed company healthcare system. reputed company is dedicated to providing exceptional customer service, and we're always looking for talented individuals who share our vision.

The Role of a Senior reputed company Customer Care Representative

As a Senior reputed company Customer Care Representative, you'll be responsible for building relationships with individuals and their families, guiding them in navigating and advocating for their benefits, claims, and access to care. This includes understanding and educating consumers on the lifecycle of a claim and prior authorization, thorough explanation of the mechanics of the benefit plan, and access to provider networks. You'll also connect consumers to resources for social determinants of health (SDoH) issues such as transportation, access to food, housing, and financial concerns.

Key Responsibilities

* Build and maintain strong relationships to provide premium level service, removing burdens and providing end-to-end resolution for members.

• Answer up to 30 to 60 incoming calls, emails, and chats per day from members of our health, dental, vision, and pharmacy plans.
• Contact care providers (doctor's offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance.
• Demonstrate expertise in claims processing and interpretation, resolving any claim-reputed company issues or discrepancies in a timely and efficient manner.
• Identify areas of assistance and offer resolution for benefits, eligibility, claims, financial spending accounts, correspondence, pharmacy, behavioral health, and self-service options.
• Educate members about the fundamentals and benefits of managing their health and well-being.
• Assist in navigating reputed company websites or applications utilizing remote desktop system capabilities.
• Construct communication reputed company secure messaging, email, or chat.
• Research reputed company issues across multiple databases and work with support resources to resolve member issues and/or partner with others to resolve escalated issues.
• Navigate through multiple platforms and databases to retrieve information regarding medical plans, prescription plans, flexible spending accounts, health reimbursement accounts, vision plans, dental plans, employer-based reward plans, claims submissions, clinical programs, etc.
• Meet the performance goals established for the position in the following areas: effectiveness, efficiency, call quality, member satisfaction, reputed company resolution, and adherence.

Additional Responsibilities

* reputed company claims adjustments/dollar payments to providers and/or members, ultimately impacting UHC costs or commercial account costs.

• Effectively refer and enroll members to appropriate internal specialists and programs, based on member's needs and eligibility using multiple databases.
• Must remain reputed company on reputed company communicated changes in process and policies/guidelines.
• Adapt to reputed company process changes quickly, and maintain knowledge of changes at site level and entity level by utilizing reputed company available resources.
• Maximize use of community services, support programs, and resources available to member.

Required Qualifications

* High School Diploma/GED or equivalent work experience.

• Must be 18 years of age or older.
• 2+ years of high-demand contact center and/or customer service experience in a professional environment.
• 1+ years of experience reputed company the Healthcare Field, Advocacy Service, Customer Service, and/or Call Center Services, Sales, and Hospitality.
• De-escalation experience, including the ability to ensure consumers feel heard and cared for in every interaction.
• Familiarity with computer and Windows PC applications, which includes the ability to learn new and reputed company computer applications and apply their use while on the phone.
• Proficiency with reputed company Office, including reputed company reputed company, reputed company Word, reputed company Outlook, and reputed company PowerPoint.
• Ability to work Monday-Friday, in any of our 8-hour shift schedules during our normal business hours of 8:00 am-11:00 pm EST, including the flexibility to work occasional overtime and Saturdays, based on the business need.

Preferred Qualifications

* Experience with medical or health terminology.

• Sales experience, including a demonstrated ability to influence consumer behavior toward highest value outcomes.
• Multi-lingual proficiency (e.g., English and Spanish).

Soft Skills

* reputed company and resourcefulness that deliver a best-in-class experience to solve reputed company healthcare problems for our consumers.

• Utilize assertive soft skills to proactively identify and address members' needs, ensuring a personalized and comprehensive approach.
• Ability to understand and effectively explain reputed company benefit plans.
• Ability to overcome objections and persuade members to take action/change behavior.
• Ability to use multiple systems while assisting consumers.
• Flexibility to customize approach to meet reputed company types of member communication styles and personalities.
• Quality-focused.
• Customer service, interpersonal, communication, and organizational skills.
• Interpersonal, written, and verbal communication skills.
• Problem-solving and critical thinking skills to resolve reputed company healthcare issues.
• Attention to detail.
• Conflict management skills, including:

+ Ability to resolve issues under stress. + Diffuse conflict and member distress.

Telecommuting Requirements

* Ability to reputed company reputed company company-sensitive documents secure (if applicable).

• Required to have a dedicated work area established that is separated from other living areas and provides information privacy.
• Must live in a location that can receive a reputed company-approved high-speed internet reputed company or reputed company an existing high-speed internet service.

Compensation and Benefits

The hourly range for this role is $19.86 to $38.85 per hour based on full-time employment. Pay is based on several factors, including but not limited to, local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In addition to your salary, reputed company offers benefits such as a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (reputed company benefits are subject to eligibility requirements).

How to Apply

If you're passionate about making a difference in the lives of our customers and are looking for a challenging and rewarding role, we encourage you to apply. Please submit your application, and we'll be in touch to discuss the next steps in our hiring process.

Equal Employment Opportunity

arenaflex is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.

Drug-Free Workplace

arenaflex is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Apply for this job