Experienced Customer Experience Representative III (Remote) – Healthcare Industry

At arenaflex, we are dedicated to delivering exceptional customer experiences that meet the evolving needs of our members and providers. As a key member of our customer experience team, you will play a vital role in providing top-notch support, resolving issues, and exceeding customer expectations. If you are passionate about delivering world-class service and have a knack for building strong relationships, we encourage you to apply for this exciting opportunity.

Job Summary

As an Experienced Customer Experience Representative III, you will be responsible for providing exceptional customer support to arenaflex members and providers across multiple states and products. You will handle a high volume of calls, chats, emails, and other communication channels, providing product and service information, identifying opportunities to improve member and provider experiences, and resolving issues in a fair and effective manner. Your primary goal will be to deliver a seamless and personalized experience that exceeds customer expectations and drives member retention.

Key Responsibilities

* Provide service support to members and providers using one or more contact center communication channels, including phone, chat, email, and off-phone work, across multiple states and products.

• Handle escalated calls on behalf of management, providing expert-level support and resolving complex issues.
• Provide excellent customer service for all call center communication channels, ensuring a positive and personalized experience for every interaction.
• Accurately document all member and provider communication, maintaining accurate records and ensuring compliance with regulatory requirements.
• Work regularly scheduled shifts within our hours of operation, including weekends and overtime as needed, to ensure 24/7 support for our members and providers.
• Build rapport with customers, responding to their needs in a compassionate and empathetic manner, and exceeding their expectations.
• Listen skillfully, collect relevant information, determine immediate requests, and identify customer needs to provide effective solutions.
• Achieve individual performance goals established for this position in areas such as call quality, attendance, and scheduled adherence.
• Engage and collaborate with other departments to ensure seamless support and resolution of issues.
• Demonstrate personal responsibility and accountability by taking ownership of calls and issues, following them through to resolution, and providing timely follow-up with customers.
• Support member needs for a wide variety of inquiries and assistance involving benefits, claims, premiums, and other areas, including complex issues.
• Support provider needs for a wide variety of inquiries and assistance involving claims, authorizations, appeals, contracting, credentialing, and other areas, including complex issues.
• Proficient in three or more lines of business, including Medicare, Medicaid, Marketplace, and MMP, for members services, provider services, and member retention.
• Respond to incoming calls from providers on a variety of issues, including highly complex or executive issues.
• Complete research for state, legislative, or regulatory inquiries as applicable.
• Gather information to critically evaluate options, seeking alternative perspectives to identify root causes and develop solutions.
• Achieve individual performance goals as it relates to call center objectives.
• Proactively engage and collaborate with other departments as required.
• Demonstrate personal responsibility and accountability by meeting or exceeding attendance and schedule adherence expectations.
• Assist with formal training needs of other employees, including new hire or training classes as needed.
• Support provider and member needs for a wide variety of inquiries involving member eligibility and covered benefits.
• Provide inquiry assistance involving claims, authorizations, appeals, contracting, credentialing, and other provider-related issues.
• Support other inquiry areas, including complex issues.
• Conduct initial research and work to immediately resolve issues.
• Appropriately escalate issues based on established risk criteria.
• Recommend and implement programs to support member needs.
• Resolve member inquiries and complaints fairly and effectively to ensure member retention.
• Respond to incoming calls from members and providers.
• Conduct member satisfaction assessment services and other member surveys as applicable and based on business needs.
• Assist other retention or inbound functions as dictated by service level requirements.
• Remain professional and courteous in verbal and written communications, utilizing concise and effective language at all times.

Essential Qualifications

* Associate's Degree or equivalent combination of education and experience.

• 3-5 years of customer service or sales experience in a fast-paced, high-volume environment.
• Proficient in multiple communication channels, including phone, chat, email, and off-phone work.
• Strong problem-solving and critical thinking skills, with the ability to analyze complex issues and develop effective solutions.
• Excellent communication and interpersonal skills, with the ability to build rapport with customers and provide personalized support.
• Ability to work in a team environment, collaborating with other departments to ensure seamless support and resolution of issues.
• Strong attention to detail, with the ability to accurately document all member and provider communication.
• Ability to work in a fast-paced environment, handling multiple calls and tasks simultaneously.
• Strong time management and organizational skills, with the ability to prioritize tasks and meet deadlines.

Preferred Qualifications

* Bachelor's Degree or equivalent combination of education and experience.

• 5-7 years of customer service or sales experience in a fast-paced, high-volume environment.
• Broker/Healthcare insurance licensure.
• Proficient in multiple software systems, including Microsoft Office, Genesys, Salesforce, Pega, QNXT, CRM, Verint, Kronos, Microsoft Teams, Video Conferencing, CVS Caremark, Availity, Molina Provider Portal, and others as required by line of business or state.

Work Environment and Company Culture

At arenaflex, we are committed to creating a positive and inclusive work environment that supports the growth and development of our employees. Our company culture is built on the values of empathy, integrity, and innovation, and we strive to deliver exceptional customer experiences that meet the evolving needs of our members and providers. As a remote employee, you will have the flexibility to work from home and enjoy a work-life balance that suits your needs.

Compensation and Benefits

arenaflex offers a competitive benefits and compensation package, including:

• Hourly pay rate: $13.41 - $29.06
• Opportunities for career growth and professional development
• Comprehensive benefits package, including medical, dental, and vision insurance
• 401(k) retirement plan with company match
• Paid time off and holidays
• Flexible work arrangements, including remote work options
• Access to cutting-edge technology and tools
• Collaborative and supportive work environment

How to Apply

If you are passionate about delivering exceptional customer experiences and have a knack for building strong relationships, we encourage you to apply for this exciting opportunity. Please submit your application through our website, including your resume, cover letter, and any relevant certifications or licenses.

Equal Opportunity Employer

arenaflex is an Equal Opportunity Employer (EOE) and welcomes applications from diverse candidates. We are committed to creating a workplace that is inclusive and respectful of all employees, and we strive to deliver exceptional customer experiences that meet the evolving needs of our members and providers. Apply for this job