What are the responsibilities and job description for the Claims Trainer position at Centers Plan for Healthy Living/Centers Care Solutions?
JOB SUMMARY
The Claims Trainer is responsible for planning, developing and delivering training programs that meet specific needs for the Claims Department. The trainer will collaborate with the claims management team to identify and analyze learning gaps and opportunities to facilitate staff development and promote continued high performance.
PRIMARY RESPONSIBILITIES
Designs, develops, and implements training programs, material and curriculum that identify learning and educational needs of the department.
Delivers training through one-on-one sessions, new hire onboarding, mentoring, classroom presentations, workshops to ensure consistency and compliance throughout department.
Identifies learning gaps and opportunities in collaboration with the claims Quality team and the Claims Integrity Department.
Based on identified learning gaps develops training strategies and priorities to achieve improvement.
Develops Performance Improvement Plan in collaboration with claims management and the Quality team as needed.
Works with other departments to provide training on the claim application.
Works will all levels of claims management to develop workflows and policies
Conducts testing of the claim system with regard to configuration changes, new product implementations and annual testing.
EDUCATION:
Bachelor’s degree preferred.
EXPERIENCE:
1-3 years of training and development experience preferred.
1-3 years of claim handling experience required
KNOWLEDGE and SKILLS
Must possess a sound working knowledge of industry claim procedures and understand the lifecycle of a claim.
Must have excellent presentation skills.
Strong written and verbal communication skills are essential.
Must possess an understanding of ICD10, CPT and HCPCS coding
Knowledge of Medicare payment methodology such as DRG and APC
Strong facilitation and development skills preferred.
Must be organized and detailed oriented.
Proficient in computer skills a must (Word, Excel, Access and PowerPoint, e-Learning tools)
Travel to other claim processing sites is required.
Salary : $28 - $33
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