Experienced Remote Customer Service & Claims Resolution Specialist – National Healthcare Support Opportunity (Work From Home, U.S.)

Join arenaflex and Help Shape the Future of Compassionate Health Care Support

Are you a motivated, service-driven professional who thrives in a fast-paced, people-centered environment? Do you want to make a tangible difference in the lives of millions of Americans while working from the comfort of your own home? arenaflex invites you to apply for an exciting, fully remote Customer Service and Claims Resolution Specialist role that combines meaningful work with the flexibility of a national telecommute position. This opportunity is ideal for individuals who are passionate about helping others, excel at problem-solving, and are ready to grow a long-term career in one of the most impactful industries in the world — health care.

At arenaflex, we are redefining the health care experience. Our mission is to simplify the complexities of medical coverage, create healthier communities, and break down the barriers that prevent individuals and families from receiving quality, affordable care. Every phone call you answer, every claim you review, and every member interaction you handle contributes to a larger purpose: making the health care system more responsive, more equitable, and more human. If you are ready to bring your empathy, professionalism, and drive to a team that truly values your contribution, this is your moment.

About the Role

As a Customer Service and Claims Resolution Specialist at arenaflex, you will operate in a dual-capacity role that blends inbound customer support with detailed claims processing. Your day will be filled with meaningful conversations and important analytical work, all designed to ensure our members receive accurate information, fair outcomes, and an exceptional experience.

This is not a small opportunity — it is a chance to do your life's best work while helping real people navigate some of the most important moments in their health care journey. Whether you have years of experience or are looking to build a new career path, arenaflex provides paid, structured on-the-job training, ongoing coaching, and a clear development pathway to help you succeed.

Key Responsibilities

• Deliver World-Class Member Support: Answer a high volume of inbound calls from members seeking assistance with health care eligibility, billing, payments, treatment authorizations, and explanation of benefits (EOBs). Identify the type of support each caller needs and route the conversation accordingly.
• Active Listening and Information Gathering: Ask thoughtful, targeted questions, listen with empathy, and document essential details accurately within our computer systems. Your ability to capture the right information will directly impact the quality of the member experience.
• End-to-End Problem Resolution: Take ownership of member issues and follow each through to a complete resolution — whether in real time on the call or through timely, well-coordinated follow-up. You will be empowered to make decisions that benefit our members.
• Claims Review and Research: Process incoming health care claims submitted by members and providers (doctors, clinics, facilities, etc.) by navigating multiple systems and platforms. Verify critical data such as pricing, prior authorizations, and applicable benefits.
• Apply Benefits with Precision: Ensure the correct benefits are applied to every claim by following established processing policies, grievance procedures, state mandates, CMS/Medicare guidelines, and benefit plan documents.
• Collaborative Communication: Work directly with members and providers to resolve disputes, clarify information, and answer questions using clear, respectful, and easily understood language.
• Performance Excellence: Meet and exceed key performance indicators in the areas of efficiency, accuracy, quality, member satisfaction, and attendance. You will receive ongoing feedback, coaching, and recognition for your achievements.

Work Schedule and Training

This is a full-time position requiring 40 hours per week, Monday through Friday. Employees must have the flexibility to work any of our 8-hour shift schedules between 7:00 a.m. and 7:00 p.m. Central Standard Time (CST). Occasional overtime may be required based on business needs.

We provide multiple weeks of paid, on-the-job training, scheduled Monday through Friday between 7:00 a.m. and 7:00 p.m. CST. You do not need prior health care or claims experience to succeed — we will equip you with the knowledge, tools, and confidence you need to thrive. All training takes place during your regular 8-hour shift.

Minimum Qualifications

• Education: High School Diploma or GED OR 10 years of equivalent professional work experience.
• Age Requirement: Must be 18 years of age or older.
• Claims Experience: 2 years of current or previous claims processing experience with the UMR CPS (claims processing system). UMR is a third-party administrator (TPA) solution. Candidates must have been employed by UMR specifically to have gained this experience.
• Customer Service Experience: At least 1 year of customer service experience in a professional office or call center environment.
• Schedule Flexibility: Ability to complete training and ongoing shifts within the 7:00 a.m. – 8:00 p.m. CST window, Monday through Friday.
• Reliability: Consistent attendance and punctuality are essential to success in this role.

Preferred Qualifications

• Familiarity with medical terminology, health plan documents, or benefit plan design.
• Prior experience navigating multiple systems and platforms simultaneously while actively speaking with a member.

Essential Soft Skills and Competencies

• Technical Aptitude: Demonstrated comfort with computers, Windows-based applications, and the ability to learn new programs quickly. Strong keyboard and navigation skills are a must.
• Empathy and Rapport Building: A natural ability to connect with people, respond with compassion, and consistently exceed customer expectations in a respectful and timely manner.
• Active Listening: Skilled at gathering relevant information, identifying immediate needs, and anticipating the future needs of each member.
• Adaptability: Flexibility to tailor your communication style to suit a wide variety of personalities, emotional states, and cultural backgrounds.
• Problem-Solving Mindset: Ability to quickly assess situations, think critically, and formulate effective recommendations on the spot.
• Conflict Resolution: Strong de-escalation skills with the ability to remain calm, professional, and resilient in stressful or emotionally charged conversations.
• Multi-Tasking Mastery: Comfortable managing multiple priorities, systems, and conversations at once without sacrificing quality or accuracy.
• Product Knowledge: Ability to learn and retain details about multiple health plan products and benefit structures.

Telecommuting and Home Office Requirements

• Ability to maintain the security and confidentiality of all company-sensitive documents.
• A dedicated, private work area within your home that is physically separated from common living spaces to ensure information privacy.
• Reliable, high-speed internet service approved by arenaflex (or an existing service that meets company standards).
• Willingness to adhere to all arenaflex Telecommuter Policy guidelines.

Compensation and Benefits

For candidates residing in California, Colorado, Connecticut, Hawaii, Nevada, New Jersey, New York, Washington, or Rhode Island, the hourly pay range is $16.54 – $32.55 per hour, based on education, prior work experience, certifications, and other relevant factors. For candidates residing in other U.S. states, compensation will be competitive and aligned with market standards.

In addition to a strong base pay, arenaflex offers a comprehensive benefits package that may include:

• Medical, dental, and vision insurance plans
• Paid time off (PTO), holidays, and personal days
• 401(k) retirement plan with company contribution
• Employee stock purchase program
• Incentive and recognition programs
• Life insurance, short-term disability, and long-term disability coverage
• Wellness programs and mental health support resources
• Tuition reimbursement and ongoing learning opportunities

All benefits are subject to eligibility requirements. No matter where you begin your career with arenaflex, you will discover a wide range of benefits and incentive programs designed to support your health, your family, and your future.

Our Mission, Culture, and Values

At arenaflex, our mission is clear: help people live healthier lives and make the health care system work better for everyone. We believe that every individual — regardless of race, gender, sexuality, age, geography, or income — deserves the opportunity to live their healthiest life. We are deeply committed to mitigating health disparities, improving outcomes for historically marginalized groups, and delivering equitable care to every community we serve.

Our culture is built on inclusion, respect, and the belief that diversity makes us stronger. arenaflex is proud to be an Equal Employment Opportunity and Affirmative Action employer. We evaluate every qualified applicant fairly, without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by applicable law.

arenaflex is also a drug-free workplace. All candidates must successfully pass a pre-employment drug screening before beginning employment.

Career Growth and Development

When you join arenaflex, you gain access to a long-term career path, not just a job. We invest heavily in our people — because we know that your success drives ours. Through structured training, mentorship, performance coaching, and internal promotion opportunities, you can grow into roles across customer service, claims management, training and quality, leadership, and beyond. Whether your goal is to become a senior claims analyst, a team lead, a quality auditor, or a subject matter expert in a specialized area, we will help you get there.

Why Work From Home With arenaflex?

Telecommuting with arenaflex means more than skipping the commute. It means working in a flexible, supportive environment that respects your work-life balance while giving you the tools and autonomy to do your best work. You will have the structure of a world-class organization and the freedom of a remote-first role — all while being part of a collaborative, mission-driven team that genuinely cares about the people we serve.

Your Next Step Starts Here

If you are a compassionate problem-solver who wants to build a meaningful career in a growing industry, arenaflex wants to hear from you. This is your opportunity to combine customer service excellence with claims processing expertise — all from a remote position anywhere in the United States. Bring your empathy, your attention to detail, and your drive to succeed, and we will provide everything else you need to thrive.

Apply today and start building the career you have always wanted. arenaflex is ready to invest in you — and together, we will make the health care system work better for everyone.