At arenaflex, we are dedicated to simplifying the health care experience and creating healthier communities. As an IFP Customer Service Advocate, you will play a crucial role in this mission by assisting customers with their health benefits inquiries. This position allows you to work remotely from anywhere in the U.S., providing you with the flexibility to balance your work and personal life while making a significant impact on the lives of millions.
**About arenaflex**
arenaflex is a leading health care organization that is committed to providing innovative solutions to improve the health and well-being of our members. We believe that everyone deserves access to quality health care, and we are dedicated to making that a reality. Our team of passionate and compassionate professionals is dedicated to delivering exceptional service and support to our members, and we are looking for talented individuals like you to join our team.
**Job Summary**
As an IFP Customer Service Advocate, you will be responsible for answering incoming calls from customers, addressing their questions about health benefits, and guiding them through the enrollment process for new plans. This role is not just about answering questions; it's about being an advocate for our customers and ensuring they receive the support they need. You will be working with a vulnerable population that may require additional support, and your ability to multi-task and show compassion will be essential.
**Responsibilities**
* Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e. benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs))
* Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems
* Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member
* Review and research incoming healthcare claims from members and providers (doctors, clinics, etc) by navigating multiple computer systems and platforms and verifies the data/information necessary for processing (e.g. pricing, prior authorizations, applicable benefits)
* Ensure that the proper benefits are applied to each claim by using the appropriate processes and procedures (e.g. claims processing policies and procedures, grievance procedures, state mandates, CMS/Medicare guidelines, benefit plan documents/certificates)
* Communicate and collaborate with members and providers to resolve issues, using clear, simple language to ensure understanding
* Meet the performance goals established for the position in the areas of: efficiency, accuracy, quality, member satisfaction and attendance
**Key Performance Indicators (KPIs)**
* Handle 50-70 calls per day, with an average call time of 10-15 minutes
* Achieve a first call resolution (FCR) rate of 80% or higher
* Meet or exceed monthly performance goals in the areas of efficiency, accuracy, quality, member satisfaction and attendance
* Maintain a high level of customer satisfaction, with a Net Promoter Score (NPS) of 80 or higher
**Requirements**
* High School Diploma / GED OR equivalent work experience
* Must be 18 years of age OR older
* 2+ years of customer service experience
* Ability to work full-time, Monday - Friday between 7:00am - 6:00pm CST including the flexibility to work occasional overtime given the business need
**Nice-to-haves**
* Health Care/Insurance environment (familiarity with medical terminology, health plan documents, or benefit plan design)
* Social work, behavioral health, disease prevention, health promotion and behavior change (working with vulnerable populations)
* Sales or account management experience
* Bilingual fluency in English and Spanish
**Benefits**
* Comprehensive benefits package
* Incentive and recognition programs
* Equity stock purchase
* 401k contribution
**Career Growth Opportunities**
arenaflex is committed to the growth and development of our employees. As an IFP Customer Service Advocate, you will have opportunities to advance your career and take on new challenges. We offer a range of training and development programs, including:
* Virtual training sessions to help you develop your skills and knowledge
* Mentorship programs to help you navigate your role and advance your career
* Opportunities to take on new responsibilities and challenges
* A range of benefits and incentives to help you grow and develop in your career
**Work Environment and Company Culture**
arenaflex is a dynamic and fast-paced organization that is committed to delivering exceptional service and support to our members. Our team of passionate and compassionate professionals is dedicated to making a difference in the lives of our members, and we are looking for talented individuals like you to join our team.
* Work from home with the flexibility to balance your work and personal life
* Collaborate with a team of passionate and compassionate professionals who are dedicated to making a difference
* Participate in a range of training and development programs to help you grow and develop in your career
* Enjoy a comprehensive benefits package, including health, dental, and vision insurance, as well as a 401k contribution
**How to Apply**
If you are a motivated and compassionate individual who is passionate about making a difference in the lives of others, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, to [insert contact information]. We look forward to hearing from you!
**Equal Employment Opportunity**
arenaflex is an equal employment opportunity employer and welcomes applications from diverse candidates. We are committed to creating a workplace that is inclusive and respectful of all employees, and we are proud to be an equal opportunity employer.