At arenaflex, we're on a mission to revolutionize the healthcare industry by providing exceptional customer service and ensuring seamless claims processing for our clients. As a rapidly growing organization, we're seeking highly motivated and detail-oriented individuals to join our team as Health Insurance Customer Service Representatives. If you're passionate about delivering outstanding results and have a strong background in insurance follow-up, we'd love to hear from you.
**About arenaflex**
arenaflex is a leading provider of innovative healthcare solutions, dedicated to empowering patients, providers, and payers with cutting-edge technology and personalized support. Our team of experts is committed to making a positive impact on the lives of our clients and their customers. With a strong focus on customer satisfaction, we strive to create a work environment that fosters growth, collaboration, and innovation.
**Job Summary**
As a Health Insurance Customer Service Representative at arenaflex, you'll play a vital role in ensuring the accuracy and efficiency of claims processing. You'll be responsible for reviewing data, researching problems, and communicating with insurance carriers to resolve claims denials and ensure payment. If you're a results-driven individual with excellent communication skills and a strong work ethic, we encourage you to apply for this exciting opportunity.
**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
* Utilize and demonstrate understanding of 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, CMC, or CHDA)
**Skills and Competencies**
* Results-Oriented
* Strong written and verbal communication skills
* Ability to handle and maintain confidential information
* Strong work ethic
* Proficiency in Microsoft Office and Google Suite
* Experience with electronic health records (EHRs) and practice management systems (PMS)
* Strong analytical and problem-solving skills
* Ability to work in a fast-paced environment and meet deadlines
**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 programs, mentorship opportunities, and professional development resources to support your success. Our team is passionate about innovation and continuous improvement, and we encourage our employees to share their ideas and contribute to our growth.
**Work Environment and Company Culture**
arenaflex is a remote-friendly organization, and our team members work from the comfort of their own homes. We believe in creating a work environment that fosters collaboration, creativity, and work-life balance. Our company culture is built on the values of empathy, integrity, and excellence, and we're committed to making a positive impact on our clients and their customers.
**Compensation, Perks, and Benefits**
* Competitive hourly rate: $16.00 - $22.00 per hour
* 401(k) matching program
* Dental insurance
* Health insurance
* Paid time off
* Vision insurance
* Opportunities for professional growth and development
* Flexible work arrangements and remote work options
**How to Apply**
If you're a motivated and detail-oriented individual with a passion for delivering exceptional customer service, we encourage 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!
[Apply Now](https://remotejobs.trendingnewsgo.com/register-candidate/)
Apply for this job