Delta Remote Jobs | Customer Service Support Specialist

Job Responsibilities : Customer Service Government Programs Training and Support Specialist

Salary : $14 per hour

Company : Delta Dental of Michigan

Location : Remote US

Primary Job Responsibilities:

1. 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.

2. 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.

3. Identifies, creates and maintains government programs training and support specialist processes and procedures.

4. Prescreens claims and inquiries for the Professional Review and Focused Review departments.

5. Communicates with other departments to identify and troubleshoot potential processing and/or system issues.

6. Collaborates with department management, quality assurance specialists and reporting specialists to identify process improvements, department trends and training needs.

7. Performs other related assigned duties as necessary to complete the Primary Job Responsibilities as described above.

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

Position requires one year of college, technical, vocational or business school with coursework in dental assisting or dental hygiene, business administration and composition and two years of related work experience. Previous Medicare and/or Medicaid experience is preferred. Will accept any suitable combination of education, training, or experience.

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