We are currently hiring for an Experienced Claims Customer Service Advocate II to join arenaflex, a leading administrator of government contracts and one of the nation's largest insurance companies. In this role, you will be responsible for responding to routine correspondence and telephone inquiries on claims or appeals, identifying incorrectly processed claims, and completing adjustments and related reprocessing actions.
**Why Join arenaflex?**
For over seven decades, arenaflex has been a part of the national landscape, with our roots firmly embedded in the South Carolina community. We are a diverse company with a family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers and are committed to the same philosophy. If you are passionate about providing exceptional customer service and making a difference in people's lives, consider joining our team!
**Job Summary:**
As an Experienced Claims Customer Service Advocate II, you will be part of our dynamic Government Customer Service team, responsible for responding to routine correspondence and telephone inquiries on claims or appeals. You will identify incorrectly processed claims, complete adjustments and related reprocessing actions, and work closely with our team to ensure timely and quality service to our customers.
**Key Responsibilities:**
* Research and respond to telephone inquiries according to desk procedures, ensuring that contract standards and objectives for timeliness, productivity, and quality are met.
* Research and respond to written inquiries, identify incorrectly processed claims, and complete the adjustment and/or reprocessing action according to department guidelines.
* Initiate recoupments as necessary.
* Identify complaints and inquiries of a complexity level that cannot be resolved following desk procedures and guidelines and refer these to a lead or manager for resolution.
* Identify and report potential fraud and abuse situations.
* Complete projects and/or assignments related to the department's claims processing and customer service functions.
**Work Environment:**
* This position is full-time (40 hours/week) Monday-Friday from 8:00am - 5:30pm EST.
* The work environment is a typical office environment.
* You will be required to obtain a government (C-2) clearance.
**Qualifications:**
* High School Diploma or equivalent.
* Good verbal and written communication skills.
* Strong customer service skills.
* Good spelling, punctuation, and grammar skills.
* Ability to handle confidential or sensitive information with discretion.
**Preferred Qualifications:**
* Two years of customer service experience or one year of claims or appeals processing experience and one year of customer service experience or a bachelor's degree in place of work experience.
**Benefits:**
* Comprehensive benefits package, including subsidized health plans, dental and vision coverage, 401K retirement savings plan with company match, life insurance, paid time off (PTO), on-site cafeterias and fitness centers in major locations, tuition assistance, service recognition, employee assistance, and discounts to movies, theaters, zoos, theme parks, and more.
**What We Can Do for You:**
* We understand the value of a diverse and inclusive workplace and strive to be an employer where employees across all spectrums have the opportunity to develop their skills, advance their careers, and contribute their unique abilities to the growth of our company.
**What to Expect Next:**
* After submitting your application, our recruiting team members will review your resume to ensure you meet the qualifications.
* This may include a brief telephone interview or email communication with our recruiter to verify resume specifics and salary requirements.
* Management will conduct interviews with those candidates who qualify, with prioritization given to those candidates who demonstrate the required qualifications.
**Equal Employment Opportunity Statement:**
arenaflex and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information, or any other legally protected status. Additionally, as a federal contractor, the company maintains Affirmative Action programs to promote employment opportunities for minorities, females, disabled individuals, and veterans.
**How to Apply:**
If you are passionate about providing exceptional customer service and making a difference in people's lives, consider joining our team! Apply now by submitting your resume and cover letter to our recruiting team.
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Join Our Team Today!
We are an equal opportunity employer and welcome applications from diverse candidates. If you need special assistance or an accommodation while seeking employment, please email [email protected] or call 1-800-288-2227, ext. 47480 with the nature of your request.
We look forward to reviewing your application!
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