**Experienced Claims and Customer Care Specialist – Remote Opportunity at arenaflex**

• *About arenaflex**

At arenaflex, we're dedicated to delivering exceptional health insurance services to over 1.6 million Ohioans, empowering them to achieve their best possible health and quality of life. As a leading health insurance provider, we're committed to innovation, excellence, and customer satisfaction. Our team of passionate professionals is driven by a shared vision to make a meaningful difference in the lives of our members. If you're a customer-focused individual with a passion for claims processing and a drive to succeed, we invite you to join our dynamic team as a Claims and Customer Care Specialist.

• *Job Summary**

We're seeking an experienced Claims and Customer Care Specialist to join our team in a remote work-from-home opportunity. As a key member of our team, you'll be responsible for processing routine to moderately complex claims while providing exceptional customer service through various communication channels. This role requires a unique blend of technical skills, customer service expertise, and a passion for delivering high-quality results. If you're a motivated and detail-oriented professional with a strong background in customer service and claims processing, we encourage you to apply for this exciting opportunity.

• *Responsibilities**

As a Claims and Customer Care Specialist at arenaflex, you'll have the opportunity to make a meaningful impact on our members' lives. Your key responsibilities will include:

• Processing routine claims while providing customer service via inbound call queues, ensuring timely and accurate resolution of member inquiries.
• Handling inbound calls and written inquiries from members, providers, clients, employers, and brokers, providing empathetic and knowledgeable support.
• Conducting claims or inquiry-related research under the direction of senior staff, utilizing your analytical skills to resolve complex issues.
• Assisting with projects as directed by management, demonstrating your ability to adapt to changing priorities and deadlines.
• Mentoring and training junior team members in claims processing and customer service, sharing your expertise and experience to help them grow and develop.
• Conducting complex claims research projects in response to inquiries and escalations, utilizing your technical skills and knowledge to deliver accurate and timely results.
• Providing troubleshooting support for claims issues, working collaboratively with internal stakeholders to resolve complex problems.

• *Requirements**

To be successful in this role, you'll need to possess the following qualifications and skills:

• Associate degree in business, healthcare administration, communications, or a related field, or an equivalent combination of training and experience.
• 1-5 years of customer service and/or claims experience, preferably in a call center in the health or dental insurance industry.
• Basic to advanced Microsoft Office skills, depending on the level of the position.
• Knowledge of dental benefits, services, terminology, and American Dental Association coding.
• Understanding of standard customer service best practices and principles.
• Knowledge of the Health Insurance Portability and Accountability Act (HIPAA).

• *Nice-to-Haves**

While not required, the following certifications are highly desirable:

• Certified Dental Billing Specialist (CDBS)
• Certified Dental Coder (CDC)
• Certified Dental Assistant (CDA)

• *Benefits**

As a valued member of our team, you'll enjoy a comprehensive benefits package, including:

• Employee bonus program
• 401(k) with company match up to 4% and additional company contribution
• Health Savings Account with company matching contribution
• Excellent medical, dental, vision, life, and disability insurance
• Access to an Employee Assistance Program for counseling and coaching
• Company holidays and up to 16 PTO days in the first year, with options to carry over unused PTO
• Parental leave for eligible employees after 120 days of service
• Career development programs and classes
• Tuition reimbursement up to $5,250 per year

• *Work Environment and Company Culture**

As a remote employee, you'll have the flexibility to work from home while still being part of a dynamic and supportive team. Our company culture is built on a foundation of innovation, collaboration, and customer satisfaction. We're committed to creating a work environment that's inclusive, diverse, and respectful, where every employee feels valued and empowered to succeed.

• *How to Apply**

If you're a motivated and customer-focused professional with a passion for claims processing, we invite you to apply for this exciting opportunity. Please submit your resume and a cover letter outlining your experience and qualifications. We can't wait to hear from you!

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