Remote Customer Service Representative II – Healthcare Benefits & Claims Support at arenaflex

About arenaflex – Pioneering Health Equity in Washington State

arenaflex is a leading, mission‑driven health plan dedicated to delivering high‑quality, affordable care to the diverse communities of Washington. Our purpose is rooted in a deep commitment to health equity, reducing disparities, and fostering an anti‑racist, inclusive workplace where every employee feels valued and empowered. As a fully remote organization, arenaflex leverages cutting‑edge technology and collaborative culture to support members and providers across the state, ensuring that every interaction moves us closer to a healthier, more equitable future.

Why This Role Matters

The Remote Customer Service Representative II is the frontline of arenaflex’s member‑centric approach. You will be the trusted voice that guides members and providers through complex benefit inquiries, eligibility questions, and claims status updates for Washington Apple Health, Medicare Advantage, and Cascade Select Plans. Your ability to deliver accurate, courteous, and timely information directly impacts the health outcomes of underserved populations and reinforces arenaflex’s reputation as a compassionate, reliable partner in care.

Key Responsibilities

Member & Provider Interaction

• Provide first‑call resolution for inquiries related to benefit interpretation, eligibility, claims status, and care access.
• Communicate clearly about Washington Apple Health, Medicare Advantage, and Cascade Select Plan options, ensuring members understand their coverage.
• Assist providers by explaining claim outcomes, offering guidance on next steps, and facilitating timely resolutions.
• Support members during the Medicare Annual Election Period, handling variable shifts and weekend coverage as needed.

Documentation & Data Management

• Accurately document every interaction, complaint, and resolution in arenaflex’s CRM system.
• Summarize call notes with concise, well‑structured documentation that can be referenced by other team members.
• Maintain compliance with privacy regulations and ensure member confidentiality at all times.

Quality & Performance Standards

• Meet or exceed attendance, call‑quality, and productivity metrics established by arenaflex.
• Continuously apply protocols, gather information from multiple systems, and determine appropriate actions with precision.
• Participate in ongoing training, coaching sessions, and performance reviews to sharpen skills and stay current on policy changes.

Team Collaboration & Continuous Improvement

• Collaborate with cross‑functional teams—including underwriting, claims, and provider relations—to resolve complex issues.
• Contribute ideas for process enhancements, share best practices, and help shape arenaflex’s evolving service model.
• Engage in regular team huddles, virtual meetings, and knowledge‑sharing forums to foster a dynamic, supportive environment.

Essential Qualifications

• Minimum three (3) years of call‑center experience, preferably in insurance, managed care, or a provider setting.
• Demonstrated experience with state and federal health programs, especially Washington Apple Health and Medicare Advantage.
• Strong knowledge of medical terminology, claims processing, and healthcare delivery models.
• Proven ability to work independently in a 100 % remote environment while maintaining high productivity.
• Excellent verbal and written communication skills, including fast and accurate typing.
• Proficiency with Microsoft Office Suite (Outlook, Word, Excel) and familiarity with CRM platforms.

Preferred Qualifications & Additional Skills

• Certification in Customer Service Excellence, Health Insurance Portability and Accountability Act (HIPAA) compliance, or related fields.
• Experience supporting diverse, underserved populations and a demonstrated commitment to health equity.
• Ability to analyze complex scenarios, apply protocols, and make sound decisions quickly.
• Flexibility to work varied shifts, including evenings, weekends, and holidays during peak enrollment periods.
• Strong problem‑solving, critical‑thinking, and analytical abilities.

Core Skills & Competencies

• Empathy & Active Listening: Ability to understand member concerns and respond with compassion.
• Attention to Detail: Precise documentation and data entry to ensure accurate records.
• Technical Agility: Comfortable navigating multiple software systems and troubleshooting technical issues.
• Time Management: Efficiently prioritize tasks in a fast‑paced remote setting.
• Team Orientation: Collaborative mindset that values shared success and continuous learning.

Career Growth & Development at arenaflex

arenaflex invests heavily in the professional development of its employees. As a Remote Customer Service Representative II, you will have access to:

• Structured onboarding and mentorship programs that pair you with seasoned specialists.
• Ongoing education modules covering healthcare policy updates, advanced claims handling, and customer experience best practices.
• Opportunities to transition into senior support roles, quality assurance, training, or specialized departments such as provider relations or member advocacy.
• Leadership development tracks for those aspiring to supervisory or management positions.
• Regular feedback loops, performance coaching, and clear pathways for promotion based on merit and impact.

Compensation, Perks & Benefits

arenaflex offers a competitive, non‑exempt salary structure with eligibility for overtime and a 5 % annual incentive target tied to company, department, and individual performance. Compensation is calibrated for internal equity and reflects your experience, knowledge, and skill set.

Comprehensive Benefits Package (Full‑time & Part‑time)

• Medical, Prescription, Dental, and Vision coverage.
• Telehealth services via a dedicated app.
• Flexible Spending Accounts (FSA) and Health Savings Accounts (HSA) options.
• Basic Life, AD&D, Short‑Term and Long‑Term Disability insurance.
• Voluntary Life, Critical Illness, and Long‑Term Care coverage.
• 401(k) retirement plan with a generous employer match.
• Employee Assistance Program (EAP) and Mental Fitness app for wellbeing.
• Financial coaching, identity‑theft protection, and wellness resources.
• Paid Time Off (PTO) starting at 17 days per year, plus 10 standard holidays, 2 floating holidays, and 40 hours of community service volunteer time.
• Compassionate leave, jury duty pay, and accommodations for religious or medical vaccination exemptions.

Work Environment & Physical Requirements

Your remote workspace will be your primary office. arenaflex provides guidance on ergonomic best practices to ensure comfort and productivity. The role requires:

• Sensory: Ability to speak, hear, and see clearly (near and far vision, depth perception, peripheral vision).
• Physical: Extended periods of sitting, computer use, and occasional standing; fine motor skills for typing and data entry.
• Mental: Strong multitasking capability, analytical problem‑solving, and the resilience to handle demanding situations.

Commitment to Diversity, Equity & Inclusion

arenaflex is an equal‑opportunity employer. We celebrate diversity and are dedicated to building an inclusive workforce where every voice is heard. All qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic. We actively apply an equity lens to all hiring, promotion, and retention practices.

Application Process & Requirements

To be considered for this role, candidates must:

• Successfully complete a criminal background check (reviewed on a case‑by‑case basis).
• Not be sanctioned or excluded from participation in federal or state healthcare programs.
• Meet vaccination requirements or obtain a valid medical or religious exemption.
• Be able to perform essential job functions with or without reasonable accommodation.

Join arenaflex – Make a Difference Every Day

If you are passionate about serving underserved communities, thrive in a remote, collaborative environment, and possess the expertise to navigate complex health‑plan inquiries, we invite you to become part of arenaflex’s mission‑driven team. Your dedication will help us close gaps in care, empower members, and drive systemic change across Washington’s health landscape.

Ready to apply? Click the link below to start your journey with arenaflex.

Apply Job!