Are you a customer service professional with a passion for delivering exceptional experiences and making a meaningful impact in people's lives? Do you have a strong background in health insurance and benefits, with a keen eye for detail and a knack for problem-solving? If so, we want to hear from you!
At arenaflex, we're on a mission to help people live healthier lives and make the health system work better for everyone. As a Senior Customer Service Representative, you'll play a critical role in delivering world-class support to our customers, helping them navigate the complexities of health insurance and benefits. With your expertise and passion, you'll make a real difference in people's lives, and we're excited to have you join our team!
**About arenaflex**
arenaflex is a global organization that delivers care, aided by technology to help millions of people live healthier lives. We're a company that's guided by diversity and inclusion, with a culture that values talented peers, comprehensive benefits, and career development opportunities. Our team is passionate about making a difference in the communities we serve, and we're committed to advancing health equity on a global scale.
**Job Summary**
As a Senior Customer Service Representative, you'll be responsible for providing exceptional support to our customers, helping them with a range of health insurance and benefits-related questions and issues. You'll work closely with our customers to understand their needs, provide personalized solutions, and ensure that they receive the best possible experience. You'll also be responsible for:
* Communicating common problems/questions presented by callers to appropriate Subject Matter Experts, to drive continuous improvement
* Educating callers on available products/services (e.g., features, functionality, options, additional offerings, preventive services, age-related services)
* Educating callers on self-service resources available to them, and on their responsibilities with regard to their health care coverage
* Referencing callers to other resources applicable to their questions/issues, where appropriate (e.g., pharmacists, prior authorizations, billing department)
* Reviewing/analyzing phone support data/metrics and communicating patterns/trends to internal stakeholders, as needed (e.g., leadership, Subject Matter Experts, business partners)
* Providing training/mentoring to other team members, as needed (e.g., new-hires, refresher training)
* Participating in customer site visits, as needed (e.g., to obtain feedback, provide education, clarify support processes, highlight company performance)
* Demonstrating knowledge of applicable health care terminology (e.g., medical, dental, behavioral, vision)
* Demonstrating knowledge of applicable products/services (e.g., benefit plans, disability, COBRA, FSA, HRA)
* Obtaining and applying knowledge of benefit structures/designs for contracted or acquired companies
* Ensuring compliance with applicable legal/regulatory requirements (e.g., HIPAA, state/regional requirements)
* Maintaining knowledge of information/process changes due to healthcare reform, referring to applicable company resources (e.g., dependent age, removal of lifetime limits, free preventive care services, Medical Loss Ratio)
* Demonstrating knowledge of established workflows and support processes (e.g., available resources, internal/external business partners, points of contact)
* Demonstrating knowledge of relevant internal processes impacting caller issues (e.g., claims processing, auto-adjudication)
* Identifying inaccurate/inconsistent information found in systems/tools, and communicating to appropriate resources (e.g., IBAAG, SOP, AYS, SPDs, policies/procedures)
* Applying knowledge of applicable Service Level Agreements (SLAs) and Performance Guarantees when interacting with callers
* Maintaining ongoing communications with callers during the resolution process to communicate status updates and other required information
* Maintaining focus on caller interactions without being distracted by other factors (e.g., system usage, pop-up alerts, VCC data)
* Acknowledging and demonstrating empathy/sympathy with callers' life events (e.g., wedding, birth of baby, loss of relative, recent illness)
* Managing caller conversations appropriately (e.g., provide a good first impression, command attention and respect, maintain professional tone, demonstrate confidence, de-escalate/defuse callers as needed)
* Demonstrating understanding of internal/external factors that may drive caller questions/issues (e.g., recent plan changes, mass mailings, call directing/rerouting, weather emergencies)
* Asking appropriate questions and listening actively to identify underlying questions/issues (e.g., root cause analysis)
* Gathering appropriate data/information and performing initial investigation to determine scope and depth of question/issue
* Identifying and coordinating internal resources across multiple departments to address client situations, and escalating to appropriate resources as needed
* Proactively contacting external resources as needed to address caller questions/issues (e.g., providers, labs, brokers)
* Utilizing appropriate knowledge resources to drive resolution of applicable questions/issues (e.g., websites, CRM tools, Onyx, Siebel, knowledge bases, product manuals, SharePoint)
* Identifying and communicating steps/solutions to caller questions/issues, using appropriate problem-solving skills and established guidelines, where available (e.g., workarounds, descriptions of relevant processes)
* Offering additional options to provide solutions/positive outcomes for callers (e.g., online access to relevant information, additional plan benefits, workarounds for prescription delays)
* Making outbound calls to resolve caller questions/issues (e.g., to callers, providers, brokers, pharmacies)
* Driving resolution of caller questions/issues on the first call whenever possible (e.g., first-call resolution, one-and-done)
* Ensuring proper documentation of caller questions/issues (e.g., research conducted, steps required, final resolution)
**Requirements**
* High School Diploma OR GED
* 2+ years of claims and/or provider contracting experience
* 2+ years of customer response/customer service experience
* Ability to work our normal business hours of 9:30am – 6:00pm CST
* Ability to successfully complete the Customer Service training during hours of 8:00am – 4:00pm CST, Monday – Friday, and demonstrate proficiency of the material
* Must be 18 years of age OR older
**Telecommuting Requirements**
* Reside within 30 miles of the following office location: 4770 Regent Blvd., Irving, TX 75063
* Ability to keep all 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 UnitedHealth Group approved high-speed internet connection or leverage an existing high-speed internet service
**Soft Skills**
* Ability to multitask
**What We Offer**
* Competitive salary
* Comprehensive benefits package
* Career development opportunities
* Diverse and inclusive work environment
* Recognition and rewards for performance
* Opportunities for growth and advancement
**How to Apply**
If you're a motivated and customer-focused individual with a passion for delivering exceptional experiences, we want to hear from you! Please submit your application today, and join our team of dedicated professionals who are making a difference in people's lives.