Experienced Claims and Customer Care Specialist – Delivering Exceptional Health Insurance Services and Support to Members

Welcome to arenaflex

arenaflex is a leading provider of high-quality health insurance services, dedicated to helping over 1.6 million individuals achieve their best possible health and quality of life. With a strong commitment to excellence and customer satisfaction, we are seeking an experienced Claims and Customer Care Specialist to join our team. As a Claims and Customer Care Specialist at arenaflex, you will have the opportunity to work from home and be part of a dynamic team that is passionate about delivering exceptional service and support to our members.

About the Role

The Claims and Customer Care Specialist role at arenaflex is a unique opportunity for individuals who are passionate about providing excellent customer service and have a strong background in claims processing. As a key member of our team, you will be responsible for processing routine to moderately complex claims while providing top-notch customer service through various communication channels. If you are a motivated and customer-focused individual who is looking for a challenging and rewarding role, we encourage you to apply for this exciting opportunity.

Key Responsibilities

• Process routine claims while providing customer service via inbound call queues, ensuring that all member inquiries are addressed in a timely and professional manner.
• Handle inbound calls and written inquiries from members, providers, clients, employers, and brokers, providing accurate and helpful information to resolve issues and concerns.
• Conduct claims or inquiry-related research under the direction of senior staff, utilizing your analytical skills to resolve complex issues and provide solutions.
• Assist with projects as directed by management, demonstrating your ability to work independently and as part of a team.
• Mentor and train junior team members in claims processing and customer service, sharing your knowledge and expertise to help others grow and develop in their roles.
• Conduct complex claims research projects in response to inquiries and escalations, utilizing your problem-solving skills to resolve issues and provide solutions.
• Provide troubleshooting support for claims issues, working collaboratively with other teams to resolve problems and improve processes.

Requirements

To be successful in this role, you will need to have:

• An Associate degree in business or healthcare administration, communications, or a related field, or an equivalent combination of training and experience.
• 1-5 years of customer service and/or claims experience, preferably in a call center in the health or dental insurance industry, with a strong understanding of customer service best practices and principles.
• Basic to advanced Microsoft Office skills, depending on the level of the position, with the ability to learn and adapt to new systems and technologies.
• Knowledge of dental benefits, services, terminology, and American Dental Association coding, with the ability to apply this knowledge in a practical and effective manner.
• Understanding of the Health Insurance Portability and Accountability Act (HIPAA), with a commitment to maintaining confidentiality and upholding the highest standards of integrity.

Nice-to-Haves

While not required, the following certifications are highly desirable:

• Certified Dental Billing Specialist (CDBS)
• Certified Dental Coder (CDC)
• Certified Dental Assistant (CDA)

What We Offer

At arenaflex, we are committed to providing our employees with a comprehensive range of benefits, including:

• Employee bonus program, recognizing and rewarding your contributions to our success.
• 401(k) with company match up to 4% and additional company contribution, helping you plan for your future and achieve your long-term goals.
• Health Savings Account with company matching contribution, providing you with a valuable resource to manage your healthcare expenses.
• Excellent medical, dental, vision, life, and disability insurance, giving you peace of mind and protecting your well-being.
• Access to an Employee Assistance Program for counseling and coaching, supporting your mental health and well-being.
• Company holidays and up to 16 PTO days in the first year, with options to carry over unused PTO, allowing you to rest and recharge.
• Parental leave for eligible employees after 120 days of service, supporting you during important life events.
• Career development programs and classes, helping you grow and develop in your role and advance your career.
• Tuition reimbursement up to $5,250 per year, investing in your education and future.

Career Growth and Development

At arenaflex, we are committed to helping our employees grow and develop in their careers. As a Claims and Customer Care Specialist, you will have access to a range of training and development opportunities, including career development programs and classes, tuition reimbursement, and mentorship from experienced professionals. We believe in investing in our employees and providing them with the tools and resources they need to succeed.

Work Environment and Company Culture

At arenaflex, we pride ourselves on our positive and supportive work environment. Our company culture is built on a foundation of respect, integrity, and teamwork, and we are committed to creating a workplace where everyone feels valued and empowered to contribute. As a Claims and Customer Care Specialist, you will be part of a dynamic and collaborative team that is passionate about delivering exceptional service and support to our members.

Conclusion

If you are a motivated and customer-focused individual who is looking for a challenging and rewarding role, we encourage you to apply for this exciting opportunity. As a Claims and Customer Care Specialist at arenaflex, you will have the opportunity to work from home, be part of a dynamic team, and contribute to the delivery of high-quality health insurance services to our members. Apply today and take the first step towards a rewarding and fulfilling career with arenaflex.