Job Description
Join our dynamic team at arenaflex as a South Bend - Level 2 Call Center Customer Service Representative! This role is 100% remote, giving you full control over your work environment. This position requires a strong and diverse skillset in relevant areas to drive success. Earn a reliable and steady income of a competitive salary. **About arenaflex** arenaflex is a leading provider of innovative solutions in the healthcare industry. Our mission is to empower individuals and communities to achieve better health outcomes through accessible, affordable, and high-quality services. We are committed to fostering a culture of excellence, empathy, and inclusivity, where our employees can grow, learn, and thrive. **Company Values** At arenaflex, we live by our core values: * **Make a Difference**: We strive to make a positive impact on the lives of our members, customers, and communities. * **Help First**: We prioritize the needs of others, providing exceptional support and service. * **Straight Talk**: We communicate openly, honestly, and transparently, building trust and credibility. * **Grow or Die**: We continuously learn, adapt, and innovate, driving growth and improvement. * **Victor, Not Victim**: We take ownership of our successes and setbacks, embracing challenges as opportunities for growth. **Position Summary** The Senior Customer Service Representative (L2) is responsible for providing exceptional customer service and support during inbound and outbound calls for Indiana Medicaid members. The representative is expected to manage a high volume of calls while maintaining accuracy, ensuring a seamless experience for our members. The primary roles of the position are: * Assist members with inquiries related to their Medicaid coverage, benefits, and enrollment. * Meet individual and team performance goals. * Maintain member records throughout all databases. * Transfer calls to the client's call center as appropriate. **Essential Functions** Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. * Assist members with inquiries related to their Medicaid coverage, benefits, and enrollment: + Educate members on Medicaid policies and procedures, including enrollment, redetermination, plan options, and benefits. + Provide excellent customer service by addressing customer inquiries, complaints, or concerns in a professional and courteous manner. + Report grievances and escalations using the appropriate channels. * Meet individual and team performance goals: + Focus on accuracy of information provided to all callers and utilize resources to ensure it is correct. + Focus on the quality of their calls, ensuring they understand the needs of the member, adhere to the policies and procedures, as well as meet quality metrics. + Focus on meeting the productivity metrics given, such as average wrap-up time, time spent in call, and time spent on hold. * Maintain member records throughout all databases: + Maintain accurate and up-to-date member records and documentation of all interactions in the call center system. + May assist with manual noting processes as needed. + Utilize various systems and software applications to assist members, such as electronic health record systems, eligibility systems, claims, and customer relationship management (CRM) systems. + Effectively utilize Interpretive Language Services for non-English speaking members. * Transfer calls to the client's call center as appropriate: + Assist with client outreach requests and follow up with supervisor on call resolution in a timely manner. + Assist with client outreaches as necessary for payment processing, health needs screeners, and other campaigns as needed. **Other Responsibilities** * Adhere to the company's values at all times. * Adhere to the organization's confidentiality policy and the protection of confidential information at all times, including all company policies and procedures. * Treat clients, members, patients, guests, staff, and others with care, courtesy, and respect. **Competencies** * Working knowledge in Microsoft Office and auto dialer tools. * Demonstrates the capability to efficiently manage multiple systems and software applications simultaneously. * Ability to accurately communicate summary information in a written format. * Excellent interpersonal and communication skills (both verbal and written) necessary to interact with members, staff, guests, providers, and clients, to clearly articulate complex information to a diverse population of members. * Critical thinking and listening skills. * Independent problem identification/resolution and decision-making skills. * Conflict resolution and negotiation skills. * Empathetic and sincere, superior rapport building skills. * Excellent verbal communication skills. * Familiarity with medical terminology to explain healthcare benefits and ensure each member's needs are appropriately met. * Ability to type at a minimum of 45 wpm. **Supervisory Responsibility** This position has no supervisory responsibilities. **Work Environment** This job operates in a professional office environment. This role uses standard office equipment such as computers, computer phone headsets, and phones. **Physical Demands** While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to sit, use hands to finger, handle or feel; and reach with hands and arms. Prolonged periods sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at times. **Position Type and Expected Hours of Work** This is a full-time position. Shifts are scheduled at times when the Call Center is open Monday through Friday, 7:00 a.m. to 7 p.m. Central time. Evening and weekend work may be required as job duties demand and for team meetings. **Travel** No travel is expected for this position. **Required Education and Experience** * High school diploma or GED. **Preferred Education and Experience** * One or two years' experience in insurance. * Knowledge of Medicaid. * Experience with Artiva software. * Accounts Payable experience. * Bi-lingual. **Additional Eligibility Qualifications** * Ability to handle complex accounts with little to no assistance. * Ability to use the non-conformity to escalate issues. * Ability to pass a knowledge assessment. **Benefits** * 401(k) * Dental insurance * Health insurance * Paid time off * Vision insurance **Schedule** * 8 hour shift * Weekends as needed **Application Question(s)** * What is your Salary Requirement? **Location** * Indiana (Required) **Work Location** Remote If you are a motivated and customer-focused individual who is passionate about making a difference in the lives of others, we encourage you to apply for this exciting opportunity to join our team at arenaflex. 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