Experienced Claims and Customer Care Specialist – Flexible Work-from-Home Opportunity at arenaflex
At arenaflex, we're dedicated to delivering exceptional health insurance services to our members, and we're seeking a highly skilled and compassionate Claims and Customer Care Specialist to join our team. As a key member of our team, you'll play a vital role in processing claims, providing top-notch customer service, and ensuring our members receive the best possible care.
About arenaflex
arenaflex is a leading health insurance provider, serving over 1.6 million Ohioans. Our mission is to empower individuals and families to achieve their best possible health and quality of life. We're committed to innovation, excellence, and customer satisfaction, and we're looking for talented professionals like you to help us achieve our goals.
Responsibilities
As a Claims and Customer Care Specialist at arenaflex, you'll be responsible for:
* Processing routine to moderately complex claims while providing exceptional customer service through various communication channels, including inbound calls and written inquiries.
* Handling inbound calls and written inquiries from members, providers, clients, employers, and brokers, ensuring timely and accurate resolution of issues.
* Conducting claims or inquiry-related research under the direction of senior staff, utilizing your analytical and problem-solving skills to resolve complex issues.
* Assisting with projects as directed by management, demonstrating your ability to adapt to changing priorities and deadlines.
* Mentoring and training junior team members in claims processing and customer service, sharing your expertise and knowledge to help them grow and develop.
* Conducting complex claims research projects in response to inquiries and escalations, utilizing your critical thinking and analytical skills to resolve issues.
* Providing troubleshooting support for claims issues, ensuring that our members receive timely and effective resolution.
Requirements
To be successful in this role, you'll need:
* An Associate degree in business, 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.
* Basic to advanced Microsoft Office skills, depending on the level of the position.
* Knowledge of dental benefits, services, terminology, and American Dental Association coding.
* Understanding of standard customer service best practices and principles.
* Knowledge of the Health Insurance Portability and Accountability Act (HIPAA).
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)
Benefits
As a valued member of our team, you'll enjoy a range of benefits, including:
* Employee bonus program
* 401(k) with company match up to 4% and additional company contribution
* Health Savings Account with company matching contribution
* Excellent medical, dental, vision, life, and disability insurance
* Access to an Employee Assistance Program for counseling and coaching
* Company holidays and up to 16 PTO days in the first year, with options to carry over unused PTO
* Parental leave for eligible employees after 120 days of service
* Career development programs and classes
* Tuition reimbursement up to $5,250 per year
Work Environment and Company Culture
As a remote worker, you'll have the flexibility to work from home, with regular check-ins and support from our team. We're committed to creating a positive and inclusive work environment, where you can grow and develop as a professional. Our company culture values innovation, collaboration, and customer satisfaction, and we're looking for talented individuals who share these values.
How to Apply
If you're a motivated and customer-focused professional with a passion for delivering exceptional service, we encourage you to apply for this exciting opportunity. Please submit your resume and a cover letter outlining your experience and qualifications. We can't wait to hear from you!