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Delta Dental of Michigan · 1 month ago

Customer Service Government Programs Training and Support Specialist

United States

Full-time

Remote

Entry, Mid Level

2+ years exp

Delta Dental of Michigan is one of the largest dental plan administrators in the country, focused on improving oral health through benefit plans and community support. The Customer Service Government Programs Training and Support Specialist will provide support to customers by resolving claims and inquiries, while also developing and conducting training for new hires and current staff.

Health Care

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

Perform other related assigned duties as necessary to complete the Primary Job Responsibilities as described above

Qualification

Medicare complianceMedicaid complianceClaims processingTraining content developmentDental terminologyProblem analysisMultitaskingVerbal communicationWritten communicationOrganization skills

Required

Position requires 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

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