Job Description
At arenaflex, we're dedicated to improving oral health through innovative benefit plans, advocacy, and community support. As a leading dental plan administrator, we're part of a larger mission to build healthy, smart, vibrant communities. Our All In culture is a mindset, feeling, and attitude that drives everything we do – from taking charge of our careers to helping colleagues and lending a hand in the community. We're seeking an experienced Government Programs Training and Support Specialist to join our team in Farmington Hills, MI. **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 complex claims, inquiries, grievances, and appeals. You'll analyze contacts to ensure accuracy, develop and conduct employee training, and identify process improvements. If you're passionate about delivering exceptional customer service and have a strong background in government programs, we want to hear from you. **Primary Job Responsibilities:** * Serve as primary CSR support for 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. **Minimum Requirements:** * 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. * Previous Medicare and/or Medicaid experience is preferred. * Will accept any suitable combination of education, training, or experience. * 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. **What We Offer:** * A comprehensive benefits package, including medical, dental, and vision coverage, short- and long-term disability, life insurance, 401(k) savings plans, flexible spending accounts, and 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. * A dynamic and supportive work environment that fosters a culture of diversity, equity, and inclusion. **Why Join arenaflex?** * We're a leading dental plan administrator with a rich history of innovation and community support. * We're part of a larger mission to build healthy, smart, vibrant communities. * We celebrate diverse thought and foster a culture where employees go All In – for the company, themselves, their colleagues, and their communities. * We offer a comprehensive benefits package and opportunities for career growth and development. **How to Apply:** If you're passionate about delivering exceptional customer service and have a strong background in government programs, we want to hear from you. Please submit your application, including your resume and cover letter, through our website. We can't wait to hear from you! **Equal Employment Opportunity:** arenaflex is an Equal Opportunity Employer. We celebrate diverse thought and foster a culture where employees go All In – for the company, themselves, their colleagues, and their communities. We're committed to providing equal employment and advancement opportunity within the context of our unique business environment without regard to race, color, religion, gender, gender identity, gender expression, age, national origin, 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. Apply for this job