**Customer Service Government Programs Training and Support Specialist – Empowering Healthy Communities through Exceptional Service**

Remote Full-time
At blithequark, 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 blithequark 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 Customer Service Government Programs Training and Support Specialist to join our team. **Job Summary:** We're seeking a highly skilled and motivated Customer Service Government Programs Training and Support Specialist to provide day-to-day support to internal and external customers by resolving difficult claims, inquiries, grievances, and appeals. This role will also be responsible for developing and conducting training programs for Government Programs department employees on department systems and processes, as well as 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. * Performs 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. * 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. **Skills and Competencies:** * Strong analytical and problem-solving skills. * Excellent communication and interpersonal skills. * Ability to work in a fast-paced environment and prioritize tasks effectively. * Strong attention to detail and organizational skills. * Ability to adapt to changing priorities and deadlines. * Strong knowledge of dental terminology, procedures, and insurance products. * Ability to analyze and resolve complex claims and inquiries. **Career Growth Opportunities and Learning Benefits:** At blithequark, we're committed to helping our employees grow and develop their careers. As a Customer Service Government Programs Training and Support Specialist, you'll have opportunities to: * Develop and conduct training programs for Government Programs department employees. * Collaborate with department management, quality assurance specialists, and reporting specialists to identify process improvements and training needs. * Participate in professional development opportunities, including training and education programs. * Work with a talented team of professionals who are passionate about improving oral health and building healthy communities. **Work Environment and Company Culture:** At blithequark, we celebrate our All In culture, which is a mindset, feeling, and attitude that we wrap around all that we do. We're a diverse and inclusive organization that values innovation, creativity, and collaboration. Our employees are empowered to take charge of their careers and make a meaningful impact in our communities. **Compensation, Perks, and Benefits:** We offer a comprehensive 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. * On-site fitness center. **How to Apply:** If you're a motivated and talented individual who is passionate about improving oral health and building healthy communities, we encourage you to apply for this exciting opportunity. Please submit your application through our website, and we'll be in touch to discuss your qualifications further. **Equal Employment Opportunity:** blithequark is an Equal Opportunity Employer and welcomes applications from diverse candidates. We're committed to creating an inclusive and diverse work environment that values and respects the contributions of all employees. **Contact Information:** If you have any questions or would like to learn more about this opportunity, please don't hesitate to contact us. We look forward to hearing from you! Apply for this job
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