At arenaflex, we're dedicated to helping our clients achieve their goals by providing innovative payment accuracy solutions that allow them to focus on what matters most – quality of care and healthier lives for all. As a premier independent healthcare payment integrity company in the US, we're committed to fostering an Ownership Culture that values People, Innovation, Integrity, Fun, and a strong work ethic. If you're seeking an employer who shares these values and is passionate about making a difference in the healthcare industry, then arenaflex is the place for you!
**About the Opportunity:**
We're seeking an experienced Healthcare Customer Service Specialist II (SCA) to join our team in a fully remote (work from home) setting. As a key member of our team, you'll be the primary point of contact for all providers, Medicare contractors, and other stakeholders. This role requires a high level of professionalism, accuracy, and timeliness in responding to CMS (Medicare) and provider inquiries. If you're a motivated and detail-oriented individual with excellent communication skills, we encourage you to apply for this exciting opportunity.
**Key Responsibilities:**
As a Healthcare Customer Service Specialist II (SCA) at arenaflex, you'll be responsible for:
* Maintaining a current knowledge of all contract requirements and objectives
* Developing professional working relationships with colleagues, healthcare providers, and other Medicare contractors
* Taking inbound calls from providers to answer questions and resolve complex issues
* Making outbound calls to healthcare providers as a courtesy to confirm if letters requesting records for review have been received
* Responding to assigned written communications from providers in a timely and accurate manner
* Educating providers on proper process protocols and their appeal rights
* Establishing appropriate contacts and performing necessary research to validate provider contact information
* Conducting critical due diligence follow-ups if additional research or action is required to resolve an inquiry
* Entering and updating all contact and activity information into tracking logs and the audit platform
* Researching and routing internal/external communications to the appropriate person or department
* Notifying management of escalated displeasure with the audit program, legal action, government intervention, and escalated concerns regarding audit issues and edit parameters
* Performing miscellaneous duties as assigned in a highly professional manner
**Knowledge, Skills, and Abilities Needed:**
To succeed in this role, you'll need:
* Excellent verbal and written communication skills
* Skilled in data entry and knowledge of computers
* Working knowledge of Excel
* Courteous, professional, and respectful attitude
* Strong understanding of customer service policies and processes
* Ability to learn CMS rules and regulations and understand the CMS Recovery Audit Contractor program
* Healthcare and insurance terminology knowledge preferred but not required
* Flexibility to prioritize and handle non-standard situations that may arise
* Must be detailed, organized, and able to manage various job duties as required
* Maintain a strong work ethic and attendance
**Required and Preferred Qualifications:**
To be considered for this role, you'll need:
* At least two years' experience in a call center or customer service position required
* At least one year claims processing/billing experience preferred
* High School diploma or GED is required
* Must maintain HIPAA Certification
**What We Offer:**
At arenaflex, we're committed to providing a comprehensive benefits package that supports a healthy work-life balance. Our benefits include:
* Medical, dental, vision, disability coverage options
* Life insurance coverage
* 401(k) savings plans
* Paid family/parental leave
* 11 paid holidays per year
* Sick time and vacation time off annually
* Flexible work arrangements, including remote work options
**Physical Requirements & Additional Notices:**
As a remote employee, you'll need to have access to reliable, secure high-speed Internet at your home office location. Proof of such may be required prior to an offer being made. You'll also need to maintain a regular work schedule, with occasional flexibility to accommodate non-standard situations.
**Equal Opportunity Employer:**
arenaflex is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.
**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 application through our website or by contacting our Talent Acquisition team directly.
**Note:**
arenaflex is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position:
* Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions)
* Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions
* Some positions may require the total absence of felony and/or misdemeanor convictions
* Must not appear on any state/federal debarment or exclusion lists
* Must complete the arenaflex Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures
* Other requirements may apply
All employees and contractors for arenaflex may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to arenaflex's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.