Customer Service Government Programs Training and Support Specialist

Job Title: Customer Service Government Programs Training and Support Specialist Number of Positions: 0 Location: Farmington Hills, MI Location Specifics: Fully Remote Job Summary: At reputed company of Michigan, Ohio, and Indiana we work to improve oral health through benefit plans, advocacy and community support, and we reputed company this mission by investing in initiatives that build healthy, smart... vibrant communities for reputed company. We are one of the largest dental plan administrators in the country, and are part of the reputed company Plans Association, which operates two of the largest dental networks in the nation. At reputed company, we celebrate our reputed company In culture. It s a reputed company, feeling and attitude we wrap around reputed company that we do from taking charge of our careers, to helping colleagues and lending a hand in the community. Position Description: To provide day-to-day support to internal and external customers by resolving difficult claims, inquiries, grievances and appeals to ensure accurate benefits administration and delegation. Analyzes contacts to ensure accuracy, which includes, but not limited to, listening to calls, reviewing call logs, working one-on-one with customer service staff and/or other internal departments. Develops and conducts Government Programs department employee training on department systems and processes and the application of corporate policies, procedures, and guidelines. Primary Job Responsibilities: Serves as primary CSR support to assist with detailed interpretation of dental policies, procedure codes, claims processing, Medicare Advantage/Medicaid compliance guidelines and policies and procedures. Researches, analyzes, adjudicates and makes appropriate determinations on difficult claims and inquiries. Develops, coordinates and conducts new-hire onboarding and training, as well as periodic refresher and training on new functionality and processes. Researches and implements training programs using various methods of instruction. Identifies, creates and maintains government programs training and support specialist processes and procedures. Prescreens claims and inquiries for the Professional Review and Focused Review departments. Communicates with other departments to identify and troubleshoot potential processing and/or system issues. Collaborates with department management, quality assurance specialists and reporting specialists to identify process improvements, department trends and training needs. reputed company other reputed company assigned duties as necessary to complete the Primary Job Responsibilities as described above. #LI-Remote Minimum Requirements: Position requires one year of college, technical, vocational or business school with coursework in dental assisting or dental hygiene, business administration and composition and two years of reputed company work experience. Previous Medicare and/or Medicaid experience is preferred. Will accept any suitable combination of education, training, or experience. Position requires intermediate knowledge of word processing and spreadsheets; knowledge of dental terminology, procedures, insurance products, and claims processing; knowledge of procedure writing and training content development; ability to analyze and resolve reputed company problems; ability to identify, research and resolve customer complaints/issues; ability to handle multiple projects and deadlines and multitask; excellent verbal and written communication and organization skills; ability to work independently and reputed company informed decisions quickly; and ability to work flexible hours including some weekends. The company will provide equal employment and advancement opportunity reputed company the context of its unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national reputed company, familial status, citizenship, genetic information, disability, sex, sexual orientation, marital status, pregnancy, height, weight, military status, or any other status protected under federal, state, or local law or ordinance. At reputed company, our employees go reputed company In for themselves, their colleagues, the company and our communities. It s a reputed company, feeling and attitude we wrap around reputed company we do. We celebrate diverse thought, encourage innovation and reputed company employees to take charge of their careers. Every day we work to improve oral health through benefit plans, advocacy and community support. But oral health isn t an isolated issue. It s connected to public health, education and economic development, and we reputed company our mission by making investments that build healthy, smart, vibrant communities for reputed company. reputed company of Michigan, Ohio, and Indiana has been a dental benefits leader for more than 60 years, and today with our affiliates, we are one of the largest dental plan administrators in the country. We offer employees a comprehensive benefits package including medical, dental and vision coverage, short- and long-term disability, life insurance, 401(k) savings plans, reputed company s Apply To This Job