Introduction to arenaflex
At arenaflex, we are dedicated to enhancing oral health through innovative benefit plans, advocacy, and community support. As a leading dental plan administrator in the country, we are part of a larger network that operates two of the largest dental networks in the nation. Our mission is to build healthy, smart, and vibrant communities for all, and we achieve this by investing in initiatives that promote overall well-being. We celebrate our "All In" culture, which embodies a mindset, feeling, and attitude that permeates every aspect of our work, from career development to community involvement.
Job Overview
We are seeking an experienced Customer Service Government Programs Training and Support Specialist to provide day-to-day support to internal and external customers. The successful candidate will resolve complex claims, inquiries, grievances, and appeals, ensuring accurate benefits administration and delegation. This role will also develop and conduct training programs for the Government Programs department, focusing on department systems, processes, and corporate policies.
Primary Job Responsibilities
- Serve as primary support for customer service staff, assisting with detailed interpretation of dental policies, procedure codes, claims processing, Medicare Advantage/Medicaid compliance guidelines, and policies and procedures.
- Research, analyze, adjudicate, and make determinations on difficult claims and inquiries, ensuring accuracy and consistency.
- Develop, coordinate, and conduct new-hire onboarding, training, and periodic refresher sessions on new functionality and processes, utilizing various instructional methods.
- Identify, create, and maintain processes and procedures for the Government Programs department, ensuring efficiency and effectiveness.
- Prescreen claims and inquiries for the Professional Review and Focused Review departments, ensuring timely and accurate processing.
- Collaborate with other departments to identify and troubleshoot potential processing and system issues, promoting a culture of continuous improvement.
- Work closely with department management, quality assurance specialists, and reporting specialists to identify process improvements, department trends, and training needs.
Essential Qualifications
The ideal candidate will have a combination of education, training, and experience that demonstrates their ability to succeed in this role. This includes:
- One year of college, technical, vocational, or business school with coursework in dental assisting, dental hygiene, business administration, and composition.
- Two years of related work experience, with previous Medicare and/or Medicaid experience preferred.
- Intermediate knowledge of word processing and spreadsheets, as well as dental terminology, procedures, insurance products, and claims processing.
- Ability to analyze and resolve complex problems, identify and research customer complaints, and handle multiple projects and deadlines.
- Excellent verbal and written communication, organization, and time management skills, with the ability to work independently and make informed decisions quickly.
Preferred Qualifications
While not required, the following qualifications are preferred:
- Previous experience in a training or support role, with a focus on government programs and dental benefits administration.
- Advanced knowledge of dental policies, procedure codes, and claims processing, as well as Medicare Advantage/Medicaid compliance guidelines.
- Experience with training content development, procedure writing, and instructional design.
- Strong analytical and problem-solving skills, with the ability to identify and resolve complex issues.
Skills and Competencies
To succeed in this role, the ideal candidate will possess the following skills and competencies:
- Communication skills: Excellent verbal and written communication skills, with the ability to articulate complex information in a clear and concise manner.
- Problem-solving skills: Strong analytical and problem-solving skills, with the ability to identify and resolve complex issues.
- Time management skills: Ability to prioritize tasks, manage multiple projects, and meet deadlines in a fast-paced environment.
- Collaboration skills: Ability to work effectively with cross-functional teams, including customer service staff, department management, and quality assurance specialists.
- Adaptability: Ability to adapt to changing priorities, processes, and systems, with a focus on continuous learning and improvement.
Career Growth Opportunities and Learning Benefits
At arenaflex, we are committed to the growth and development of our employees. As a Customer Service Government Programs Training and Support Specialist, you will have access to:
- Comprehensive training programs, focusing on government programs, dental benefits administration, and customer service skills.
- Ongoing professional development opportunities, including workshops, webinars, and conferences.
- Mentorship and coaching from experienced professionals, with a focus on career advancement and growth.
- Opportunities for cross-functional training and rotation, allowing you to explore different areas of the business and develop new skills.
Work Environment and Company Culture
At arenaflex, we pride ourselves on our "All In" culture, which embodies a mindset, feeling, and attitude that permeates every aspect of our work. Our work environment is:
- Collaborative: We work together as a team to achieve common goals and objectives.
- Dynamic: We are a fast-paced and ever-changing organization, with a focus on innovation and continuous improvement.
- Supportive: We prioritize the well-being and success of our employees, providing a supportive and inclusive work environment.
- Community-focused: We are committed to giving back to our communities, through volunteer opportunities, charitable donations, and community outreach programs.
Compensation, Perks, and Benefits
At arenaflex, we offer a competitive compensation package, including:
- A comprehensive salary and benefits package, with opportunities for growth and advancement.
- A range of perks and benefits, including flexible work arrangements, professional development opportunities, and access to cutting-edge technology.
- A dynamic and supportive work environment, with a focus on employee well-being and success.
Conclusion
If you are a motivated and experienced customer service professional, with a passion for government programs and dental benefits administration, we encourage you to apply for this exciting opportunity. As a Customer Service Government Programs Training and Support Specialist at arenaflex, you will have the chance to make a real difference in the lives of our customers, while developing your skills and advancing your career. Join our team and become part of a dynamic and supportive organization that is dedicated to improving oral health and building healthy, smart, and vibrant communities for all.
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