**Experienced Group Health Customer Service Representative – Claims Processing and Client Support**
At arenaflex, we're on a mission to revolutionize the way healthcare claims are processed and managed. As a Group Health Customer Service Representative, you'll play a vital role in building strong relationships with our clients, technical teams, and operations teams. If you're a highly motivated and detail-oriented individual with excellent communication skills, we want to hear from you.
**About arenaflex**
arenaflex is a fast-paced, Inc. 500 Company with a high-performance culture, dedicated to providing customized Independent Medical Exam and Peer Review programs to leading national and regional Workers' Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We process over 200,000 insurance claims annually, and our team is passionate about delivering exceptional results.
**Job Summary**
As a Group Health Customer Service Representative, you'll be responsible for scheduling and selecting reviewers for referrals received within the arenaflex Network. You'll work closely with clients, technical teams, and operations teams to ensure seamless communication and efficient claims processing. If you're looking for a challenging and rewarding role with opportunities for growth and development, we encourage you to apply.
**Key Responsibilities**
* **Handling Receipt of New Cases**
+ Intake new cases and review/verify information and requests
+ Draft cases by entering information into the arenaflex system, AccessDS
+ Work with clients on any information missing pertinent to processing claims
+ Sort, organize, and create medical document listings (if required by clients, and in line with specific special handling)
* **Oversight of Cases**
+ Monitor, process, and track cases to ensure deadlines are met
* **Assignment of Cases**
+ Assign/schedule new cases to physicians for review with the appropriate physician, based on location, reviewer availability, specific guidelines, jurisdictional requirements, and other client requirements
+ Ensure that the assigned physician has no conflict of interest with the case assignments
* **Client Interaction**
+ Update clients frequently on cases in progress
+ May communicate when there are questions on referral information to ensure proper documentation and information is provided to the assigned reviewer
+ Ensure proper documentation for specified cases is provided to the client
**Special Skills and Attributes Required**
This position involves a substantial amount of communication with clients and physicians/physicians' offices via phone and email, and constant computer work. Therefore, candidates MUST possess the following skills/experience:
* A minimum of 1 year of experience working in an administrative or clerical role in a business office environment is required
* Experience working in a healthcare (medical office, insurance claims, etc.) environment is preferred
* Excellent computer skills (Apple Operating System, Google Chrome search engine, Gmail are preferred)
* Stellar written and verbal communication skills, including a high comfort level in speaking with the referring client, claimants, and/or physician
* Ability to maintain focus and attention to detail in a fast-paced environment
* Ability to manage multiple tasks and quickly changing priorities
* Excellent organizational skills
**Required Education and Experience**
* An Associate's Degree is preferred
**Work from Home Technical Requirements**
* Supply and support their own internet services
* Maintaining an uninterrupted internet connection is a requirement of all work-from-home positions
**Benefits**
We offer a comprehensive benefits package, including:
* Generous Paid Time Off
* Excellent benefits package
* Competitive salary
* Apple equipment and media stipend for remote work space
* Strong training program to ensure a smooth onboarding process
**Why Join arenaflex?**
* Fast-paced and dynamic work environment
* Opportunities for growth and development
* Collaborative and supportive team culture
* Competitive compensation and benefits package
* Flexible work arrangements (work from home)
**How to Apply**
If you're a motivated and detail-oriented individual with excellent communication skills, we encourage you to apply for this exciting opportunity. Please submit your resume and cover letter to [insert contact information]. We can't wait to hear from you!
**Note:** arenaflex will never conduct an interview via text or request checks from candidates for purchasing equipment.
**About arenaflex**
arenaflex is a fast-paced, Inc. 500 Company with a high-performance culture, dedicated to providing customized Independent Medical Exam and Peer Review programs to leading national and regional Workers' Compensation, Disability, Auto, and Group Health Carriers, Third-Party Administrators, Managed Care Organizations, Employers, and Pharmacy Benefit Managers. We process over 200,000 insurance claims annually, and our team is passionate about delivering exceptional results.
**Job Summary**
As a Group Health Customer Service Representative, you'll be responsible for scheduling and selecting reviewers for referrals received within the arenaflex Network. You'll work closely with clients, technical teams, and operations teams to ensure seamless communication and efficient claims processing. If you're looking for a challenging and rewarding role with opportunities for growth and development, we encourage you to apply.
**Key Responsibilities**
* **Handling Receipt of New Cases**
+ Intake new cases and review/verify information and requests
+ Draft cases by entering information into the arenaflex system, AccessDS
+ Work with clients on any information missing pertinent to processing claims
+ Sort, organize, and create medical document listings (if required by clients, and in line with specific special handling)
* **Oversight of Cases**
+ Monitor, process, and track cases to ensure deadlines are met
* **Assignment of Cases**
+ Assign/schedule new cases to physicians for review with the appropriate physician, based on location, reviewer availability, specific guidelines, jurisdictional requirements, and other client requirements
+ Ensure that the assigned physician has no conflict of interest with the case assignments
* **Client Interaction**
+ Update clients frequently on cases in progress
+ May communicate when there are questions on referral information to ensure proper documentation and information is provided to the assigned reviewer
+ Ensure proper documentation for specified cases is provided to the client
**Special Skills and Attributes Required**
This position involves a substantial amount of communication with clients and physicians/physicians' offices via phone and email, and constant computer work. Therefore, candidates MUST possess the following skills/experience:
* A minimum of 1 year of experience working in an administrative or clerical role in a business office environment is required
* Experience working in a healthcare (medical office, insurance claims, etc.) environment is preferred
* Excellent computer skills (Apple Operating System, Google Chrome search engine, Gmail are preferred)
* Stellar written and verbal communication skills, including a high comfort level in speaking with the referring client, claimants, and/or physician
* Ability to maintain focus and attention to detail in a fast-paced environment
* Ability to manage multiple tasks and quickly changing priorities
* Excellent organizational skills
**Required Education and Experience**
* An Associate's Degree is preferred
**Work from Home Technical Requirements**
* Supply and support their own internet services
* Maintaining an uninterrupted internet connection is a requirement of all work-from-home positions
**Benefits**
We offer a comprehensive benefits package, including:
* Generous Paid Time Off
* Excellent benefits package
* Competitive salary
* Apple equipment and media stipend for remote work space
* Strong training program to ensure a smooth onboarding process
**Why Join arenaflex?**
* Fast-paced and dynamic work environment
* Opportunities for growth and development
* Collaborative and supportive team culture
* Competitive compensation and benefits package
* Flexible work arrangements (work from home)
**How to Apply**
If you're a motivated and detail-oriented individual with excellent communication skills, we encourage you to apply for this exciting opportunity. Please submit your resume and cover letter to [insert contact information]. We can't wait to hear from you!
**Note:** arenaflex will never conduct an interview via text or request checks from candidates for purchasing equipment.