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Experienced Remote Customer Service Representative - Healthcare Quality Improvement & Care Management

Remote, USA Full-time Posted 2025-11-03

Join the Arsenault Team: Revolutionizing Healthcare Quality and Care Management

At Arsenault, we're on a mission to transform the healthcare landscape by ensuring that millions of people receive the right care, at the right time, in the right setting. As a rapidly growing national quality improvement and care management organization, we're committed to making a real difference in the lives of individuals across the country. If you're a motivated and experienced Customer Service Representative looking for a new challenge, we invite you to join our team and be part of something truly impactful.

About Us: People Focused, Mission Driven

At Arsenault, we're driven by a passion to improve lives through healthcare quality and clinical expertise. Our team is comprised of dedicated professionals who share our commitment to delivering exceptional care and service. We believe in fostering a work environment that is supportive, inclusive, and empowering, where our employees can grow and thrive. Our comprehensive benefits package, training programs, and opportunities for career advancement make us an employer of choice in the industry.

The Role: Remote Customer Service Representative

As a Customer Service Representative, you will play a critical role in supporting our prior authorization process by providing exceptional service to our customers, resolving inquiries, and addressing concerns in a timely and professional manner. This is a unique opportunity to work in a dynamic, fast-paced environment where your skills and experience will be valued and utilized to drive success.

Key Responsibilities:

  • Develop and maintain a thorough understanding of internal policies, procedures, and services to effectively address customer inquiries and concerns.
  • Utilize automated systems to log and retrieve information, and perform accurate and timely data entry of electronic faxes.
  • Respond to customer inquiries via telephone, email, fax, or mail, and provide timely and accurate responses within required turnaround times.
  • Interact with hospitals, physicians, beneficiaries, and other program recipients to resolve issues and address concerns.
  • Investigate and resolve customer complaints, and escalate complex issues to the appropriate parties.
  • Meet or exceed departmental standards for call volume and service level.
  • Initiate files by collecting and entering demographic, provider, and procedure information into our system.
  • Serve as a liaison between Review Supervisors and external providers to facilitate communication and resolve issues.
  • Maintain accurate logs and documents related to incoming and outgoing calls.

What You'll Need: Essential Qualifications and Skills

Required Qualifications:

  • High School diploma or equivalent.
  • Medical terminology course(s) are desirable but not required.
  • 2+ years of customer service experience in a call center environment, preferably in the healthcare or insurance industry.

Knowledge, Skills, and Abilities:

  • Knowledge of medical terminology and the health insurance industry.
  • Ability to communicate effectively in English, both verbally and in writing.
  • Proficiency in using phone systems, electronic equipment, and software applications.
  • Strong research and investigation skills to resolve customer inquiries and concerns.
  • Ability to multitask, work in a fast-paced environment, and remain calm under pressure.
  • Effective verbal and listening skills to provide courteous and professional customer service.
  • Bilingual Spanish-English skills are highly desirable.

What We Offer: Career Growth, Benefits, and a Supportive Work Environment

At Arsenault, we're committed to supporting the growth and development of our employees. We offer comprehensive training programs, opportunities for career advancement, and a supportive work environment that fosters collaboration and innovation. Our benefits package includes:

  • Comprehensive health plans.
  • Paid time off.
  • Retirement savings plans.
  • Corporate wellness programs.
  • Educational assistance.
  • Corporate discounts.

As a remote Customer Service Representative, you'll have the flexibility to work from home while being part of a dynamic team that's making a difference in the healthcare industry. We're an Equal Opportunity Employer, committed to diversity and inclusion in the workplace.

Join Our Team: Apply Now!

If you're a motivated and experienced Customer Service Representative looking for a new challenge, we invite you to join our team at Arsenault. Apply now and be part of a organization that's shaping the future of healthcare quality and care management. Take the first step towards a rewarding career with a mission-driven organization.

Arsenault is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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