At arenaflex, we're dedicated to improving oral health through benefit plans, advocacy, and community support. As a leading dental plan administrator, we're part of the arenaflex Plans Association, which operates two of the largest dental networks in the nation. Our mission is to build healthy, smart, and vibrant communities for all, and we're looking for a talented individual to join our team as an Experienced Customer Service Government Programs Training and Support Specialist.
**Job Summary:**
As a key member of our Government Programs department, you'll provide day-to-day support to internal and external customers by resolving difficult claims, inquiries, grievances, and appeals. You'll analyze contacts to ensure accuracy, develop and conduct training programs, and collaborate with department management to identify process improvements and training needs. If you're passionate about delivering exceptional customer service and have a strong background in dental benefits administration, we encourage you to apply for this exciting opportunity.
**Primary Job Responsibilities:**
* Serve 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.
* Research, analyze, adjudicate, and make appropriate determinations on difficult claims and inquiries.
* Develop, coordinate, and conduct new-hire onboarding and training, as well as periodic refresher and training on new functionality and processes.
* Research and implement training programs using various methods of instruction.
* Identify, create, and maintain government programs training and support specialist processes and procedures.
* Prescreen claims and inquiries for the Professional Review and Focused Review departments.
* Communicate with other departments to identify and troubleshoot potential processing and/or system issues.
* Collaborate with department management, quality assurance specialists, and reporting specialists to identify process improvements, department trends, and training needs.
* Perform other related assigned duties as necessary to complete the Primary Job Responsibilities as described above.
**Essential Qualifications:**
* One year of college, technical, vocational, or business school with coursework in dental assisting or dental hygiene, business administration, and composition.
* Two years of related work experience in dental benefits administration, with a focus on government programs.
* Previous Medicare and/or Medicaid experience is preferred.
* Will accept any suitable combination of education, training, or experience.
**Preferred Qualifications:**
* 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 complex 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 make informed decisions quickly.
* Ability to work flexible hours, including some weekends.
**Work Environment and Company Culture:**
At arenaflex, we celebrate our All In culture, which is a mindset, feeling, and attitude we wrap around all that we do. We're committed to creating a diverse and inclusive work environment where employees feel empowered to take charge of their careers and make a meaningful impact. Our employees enjoy a comprehensive benefits package, including medical, dental, and vision coverage, short- and long-term disability, life insurance, 401(k) savings plans, flex spending accounts, and tuition reimbursement or educational assistance. We also offer annual incentive compensation based on annual business goals, eight hours of paid volunteer time each year, and access to an on-staff health coach and personal trainer.
**Career Growth Opportunities and Learning Benefits:**
At arenaflex, we're committed to helping our employees grow and develop their careers. We offer a range of training and development opportunities, including on-the-job training, mentorship programs, and access to industry-leading conferences and events. Our employees also have the opportunity to participate in cross-functional projects and work with other departments to identify process improvements and training needs.
**Compensation, Perks, and Benefits:**
arenaflex offers a competitive salary and benefits package, including:
* Medical, dental, and vision coverage
* Short- and long-term disability
* Life insurance
* 401(k) savings plans
* Flex spending accounts
* Tuition reimbursement or educational assistance
* Annual incentive compensation based on annual business goals
* Eight hours of paid volunteer time each year
* Access to an on-staff health coach and personal trainer
* Virtual lunchtime workouts hosted by the trainer and/or an on-site fitness center
**How to Apply:**
If you're passionate about delivering exceptional customer service and have a strong background in dental benefits administration, we encourage you to apply for this exciting opportunity. Please submit your resume and cover letter to [insert contact information]. We can't wait to hear from you!
**Equal Employment Opportunity:**
arenaflex is an Equal Opportunity Employer and welcomes applications from diverse candidates. We're committed to creating a workplace that's inclusive and respectful of all employees, and we're proud to be an employer of choice for people from all backgrounds.
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