Reimbursement Specialist (Customer Service) – Healthcare Benefits Verification & Patient Coverage Support (Remote Contract)

Join arenaflex as a Reimbursement Specialist (Customer Service) – Healthcare Benefits Verification

Are you an organized, detail-driven professional with a passion for helping patients access the care they need? arenaflex is seeking motivated, compassionate, and skilled Reimbursement Specialists to join our remote customer service team supporting a major healthcare benefits verification project. This is a meaningful opportunity to make a real difference in the lives of patients undergoing ongoing therapy while building a rewarding career in the healthcare reimbursement industry.

As a Reimbursement Specialist at arenaflex, you will play a vital role in ensuring that patients continue to receive uninterrupted medical treatment by verifying their insurance benefits, confirming coverage details, and securing prior authorizations. This fully remote contract position offers competitive hourly pay, comprehensive paid training, and the chance to work with a passionate team committed to excellence in healthcare customer service.

About the Role and What You’ll Do

This is a call center-based customer service position focused on outbound insurance verification calls. You will spend the majority of your day on the phone contacting insurance providers, physician offices, and pharmacy staff to reverify patient insurance benefits, confirm active coverage, and ensure prior authorizations are in place. The work you do directly impacts patient care by helping healthcare providers receive appropriate reimbursement for their services and preventing lapses in coverage that could disrupt critical treatment.

At arenaflex, we understand that reimbursement specialists are the backbone of the healthcare revenue cycle. That’s why we invest in thorough training, provide clear protocols and procedures, and foster a supportive team environment where your contributions are recognized and valued.

Key Responsibilities

• Outbound Insurance Verification: Place 35 or more outbound calls daily to insurance providers, verifying patient coverage, policy changes, and benefits status with accuracy and professionalism.
• Case Management: Successfully close 20 or more cases per day while maintaining a high standard of quality and compliance with program standard operating procedures (SOPs).
• Insurance Benefit Management: Collect, review, and document patient insurance benefit information according to program SOPs; complete and submit insurance forms and prior authorization requests in a timely manner while adhering to third-party payer requirements.
• Customer Service Excellence: Provide exceptional service to physician office staff, patients, insurance representatives, and internal team members; resolve inquiries promptly and escalate complaints when appropriate.
• Communication and Coordination: Maintain regular phone contact with provider representatives, third-party customer service representatives, and pharmacy staff; coordinate effectively with inter-departmental associates to ensure seamless case management.
• Documentation and Reporting: Process insurance and patient correspondence accurately; report reimbursement trends, delays, and issues to supervisors; provide complete documentation for prior authorizations including demographic details and identification numbers.
• Problem-Solving and Compliance: Analyze moderately complex problems within defined SOPs, exercising sound judgment to determine appropriate actions; report all adverse events in accordance with training and compliance requirements; perform related duties as assigned with minimal instruction.
• Prior Authorization Management: Confirm that all necessary prior authorizations are in place and valid, ensure required documentation is submitted correctly, and verify that authorizations remain active to avoid treatment interruptions.

Essential Qualifications and Requirements

• Experience: Minimum of one (1) year of experience in specialty pharmacy, medical insurance, healthcare customer service, or a related field.
• Industry Experience Premium: Candidates with two (2) or more years of experience specific to healthcare benefits verification will be eligible for an elevated pay rate of $19.00 per hour.
• Patience and Resilience: Ability to remain patient and professional during extended hold times, which may reach up to 90 minutes per client requirements.
• Technical Proficiency: Strong working knowledge of Microsoft Office Suite, including Excel, Outlook, and Word.
• Communication Skills: Excellent verbal and written communication skills with the ability to convey complex insurance information clearly and compassionately.
• Schedule Flexibility: Willingness to work a flexible schedule between 8:00 AM and 8:00 PM EST, Monday through Friday, with potential weekend overtime opportunities beginning in January 2025.
• Remote Work Setup: Must have a private, designated home workspace free from distractions to maintain focus and confidentiality.
• Education: High school diploma or equivalent required.
• Background Verification: Must pass a background check and provide employment verification for the last three (3) employers.

Preferred Skills and Competencies

• Prior experience in a high-volume call center environment, preferably in healthcare or insurance.
• Familiarity with CRM systems, insurance verification platforms, and electronic health records.
• Strong attention to detail with the ability to accurately document and verify sensitive patient information.
• Ability to navigate multiple systems and screens simultaneously while maintaining conversational flow with callers.
• Problem-solving mindset with the capacity to handle escalations professionally and efficiently.
• Self-motivation and discipline to thrive in a remote work environment.
• Understanding of HIPAA regulations and commitment to maintaining patient confidentiality.

Compensation and Schedule Details

• Pay Rate: $18.00 per hour starting rate, with an increased rate of $19.00 per hour for candidates with 2+ years of healthcare benefits verification experience.
• Employment Type: Contract, project-based role with a defined end date.
• Project Duration: Anticipated start date of December 1, 2024, with a project end date of February 15, 2025.
• Regular Schedule: Monday through Friday, 40 hours per week, within the operating hours of 8:00 AM to 8:00 PM EST. You will be assigned a specific schedule with a one-hour unpaid lunch break.
• Weekend Opportunities: Weekends may be required starting in January 2025. Overtime will be offered to volunteers first and must be client-approved.
• Holidays: Tentative days off include December 24-25, 2024, and December 31, 2024 – January 1, 2025.

Training and Onboarding

At arenaflex, we set our team members up for success from day one. This position includes approximately three (3) weeks of comprehensive paid training designed to prepare you thoroughly for your role.

• Training Schedule: Monday through Friday, 9:00 AM to 6:00 PM EST during the month of December. Training will be conducted on camera, so you must be camera-ready and prepared to engage actively.
• Training Hours: During the initial training period, you may not work a full 40-hour work week as you build your skills and confidence.
• Training Content: Your training will include practice calls, mock scenarios, CRM system navigation, client-specific program protocols, cadence training, script familiarization, and hands-on system learning during days 5-7.
• Assessments: Various assessments will be administered during training. Candidates must meet program score requirements by December 31, 2024.
• Tech Enablement Session: You will be assigned a mandatory tech enablement session during the week of December 1, 2024, to ensure your home office setup and equipment are properly configured.

Equipment and Onboarding Requirements

To ensure a smooth onboarding experience, selected candidates must complete the following steps:

• Participate in a position information session with arenaflex (face-to-face meeting).
• Sign a "Right to Represent" agreement to work with arenaflex on this project.
• Complete a position requirements checklist and action items as issued.
• Complete a Spark Hire one-way video interview, which will be the basis for the hiring decision.
• Successfully complete all new hire requirements upon selection.
• Pick up equipment in Lake Mary, FL (candidates must be able to pick up and return equipment locally).
• Complete mandatory online pre-assignment training links, including HIPAA compliance.
• Successfully complete all training requirements by December 31, 2024.
• Return all equipment in Lake Mary, FL at the end of the assignment.

Why Work with arenaflex?

At arenaflex, we believe that meaningful work starts with meaningful support. When you join our team, you become part of a community that values your skills, respects your time, and invests in your professional growth.

• Competitive Pay: We offer above-market hourly rates with premium pay for experienced healthcare verification professionals.
• Paid Training: Your training time is compensated, ensuring you can focus on learning without financial stress.
• Remote Flexibility: Work from the comfort of your home while making a meaningful impact on patient care.
• Career Development: Gain valuable experience in the healthcare reimbursement industry, a field with strong long-term growth potential.
• Supportive Culture: Join a team that prioritizes collaboration, clear communication, and mutual respect.
• Skill Building: Develop expertise in insurance verification, prior authorizations, CRM platforms, and healthcare compliance that will serve you throughout your career.

Career Growth and Learning Opportunities

This role offers an excellent foundation for anyone looking to build a career in healthcare administration, insurance verification, medical billing, or patient access services. At arenaflex, we recognize top performers and often prioritize internal candidates for future opportunities. Whether you aspire to move into team leadership, quality assurance, training, or specialized program management, the experience you gain here will open doors.

You will develop in-demand skills including healthcare communication, regulatory compliance, problem-solving in high-pressure situations, and technical proficiency with industry-standard CRM and documentation systems. These competencies are highly transferable and valued across the healthcare industry.

Our Commitment to You

arenaflex is committed to creating an inclusive, supportive, and empowering work environment. We understand that our team members are our greatest asset, and we are dedicated to providing the tools, training, and encouragement you need to succeed. From your first day of training through the completion of your assignment, you will have access to resources, support, and a team that genuinely cares about your success.

Take the Next Step in Your Career

If you are a dedicated professional with healthcare customer service experience, a passion for helping others, and the resilience to thrive in a fast-paced call center environment, we want to hear from you. This is your opportunity to join a reputable organization, earn competitive pay, gain valuable healthcare industry experience, and contribute to work that truly matters.

Don’t miss this chance to be part of a project that directly impacts patient care and healthcare provider success. Apply today and take the first step toward an exciting new opportunity with arenaflex. We look forward to welcoming you to our team!