At arenaflex, we're on a mission to revolutionize the way healthcare services are delivered, and we're looking for talented individuals to join our team as Experienced Health Insurance Customer Service Representatives. As a key member of our remote team, you'll play a vital role in ensuring the accuracy and efficiency of our claims processing, providing exceptional customer service, and driving business growth.
**About arenaflex**
arenaflex is a rapidly growing company that's passionate about making a positive impact on people's lives. We're committed to delivering innovative solutions that simplify the healthcare experience, and we're looking for like-minded professionals to join our team. Our company culture values collaboration, innovation, and customer satisfaction, and we're dedicated to creating a work environment that's inclusive, supportive, and fun.
**Job Summary**
As an Experienced Health Insurance Customer Service Representative, you'll be responsible for reviewing data to ensure the validity of insurance information for claims processing, answering inquiries involving individual accounts, and researching problems to ensure accuracy for payment. You'll work closely with insurance carriers, third-party payors, and administrative personnel to resolve claims denials, process payments, and maintain accurate account information.
**Key Responsibilities**
* Follow-Up with Insurance Carriers to determine reason for claims denial and work to resolve claim for payment.
* Process claims, payments, adjustments, refunds, denials, and unpaid insurance balances.
* Assess and correct, when needed, demographic, insurance, and financial information.
* Provide accurate account maintenance and documentation.
* Use and demonstrate understanding of the applicable computer systems, including system reports and security procedures.
* Serve as a liaison with insurance companies, third-party payors, and administrative personnel.
* Analyze EOBs and account documentation to identify, reconcile, and resolve patterns resulting in erroneous or no reimbursement.
* Review payer contracts and ensure accounts are resolved consistent with terms.
* Ability to resolve insurance denials and file appeals with government and commercial carriers.
* Accurately and efficiently process the account, including transaction recording and other functions.
* Stay up to date on contracts, regulations, procedures, and other changes affecting the department.
* Report unusual accounts, account problems, and workflow issues promptly to manager.
* Demonstrate positive and professional communication skills.
* Perform other work duties as assigned.
**Essential Qualifications**
* High School Diploma required
* 3-5 years of insurance follow-up experience in a hospital or physician's office setting is preferred
* Thorough understanding of CPT, DRG, HCPC, Procedure and Revenue codes, modifiers, and their effect on reimbursement
* Experience with filing UB-04 and HCFA 1500 claim form required
* Background check and random drug screens
**Preferred Qualifications**
* Bachelor's degree in a related field (e.g., healthcare administration, business, or finance)
* Previous experience in a customer service or claims processing role
* Knowledge of healthcare regulations and industry standards
* Certification in a related field (e.g., CPC, CCS, or CMC)
**Skills and Competencies**
* Results-Oriented
* Strong written and verbal communication skills
* Ability to handle and maintain confidential information
* Strong work ethic
* Analytical and problem-solving skills
* Attention to detail and accuracy
* Ability to work in a fast-paced environment and meet deadlines
* Strong organizational and time management skills
* Ability to work independently and as part of a team
**Career Growth Opportunities and Learning Benefits**
At arenaflex, we're committed to helping our employees grow and develop their careers. We offer a range of training and development programs, including:
* On-the-job training and mentorship
* Online courses and webinars
* Industry conferences and workshops
* Leadership development programs
* Career advancement opportunities
**Work Environment and Company Culture**
As a remote employee, you'll have the flexibility to work from the comfort of your own home or office. Our company culture values collaboration, innovation, and customer satisfaction, and we're dedicated to creating a work environment that's inclusive, supportive, and fun. We offer a range of benefits and perks, including:
* Flexible work schedule
* Remote work options
* Collaborative and supportive team environment
* Opportunities for career growth and development
* Recognition and rewards for outstanding performance
* Access to cutting-edge technology and tools
* Comprehensive benefits package, including health insurance, dental insurance, vision insurance, and 401(k) matching
**Compensation and Benefits**
* Hourly rate: $16.00 - $22.00 per hour
* Benefits package, including:
+ Health insurance
+ Dental insurance
+ Vision insurance
+ 401(k) matching
+ Paid time off
+ Flexible work schedule
* Opportunities for career growth and development
* Recognition and rewards for outstanding performance
**How to Apply**
If you're a motivated and results-driven individual who is passionate about delivering exceptional customer service, we encourage you to apply for this exciting opportunity. Please submit your resume and a cover letter outlining your experience, skills, and qualifications. We can't wait to hear from you!