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Claims Training Specialist II

In United States

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Claims Training Specialist II   

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JOB TITLE:

Claims Training Specialist II

JOB TYPE:

JOB SKILLS:

JOB LOCATION:

Los Angeles, CA United States

JOB DESCRIPTION:

Job Summary The Claims Training Specialist II is primarily responsible for designing and conducting training programs using established departmental guidelines. This position is responsible for providing ongoing training on the core processing system, claims processing procedures, communicating regulatory changes which will affect established procedures, establishing quality and performance guidelines, creating and maintaining departmental policy and procedures, and working with the Claims Compliance Manager to monitor and track individual performance. Duties Build competencies for the Claims Department by designing and conducting training programs that will boost employee’s workplace performance in alliance with Enterprise and departmental goals. Responsible for performing training needs assessments with the Claims Compliance Manage and will assist in designing and delivering curriculum and learning materials to ensure the success of new and current Claims Examiners.  Work with document specialists to create training presentations and with Human Resource to customize training for inclusion into the L.A Care University.  Quality review of processed claims. Develop and create reports to determine area of improvement in claims processing for department.  Researching provider and member grievances to identify error trends and training opportunities. Create and develop tracking and trending mechanisms to identify type of grievances/ complaints for Claims Department. Conduct assessments after training to measure, record, and report feedback on training material and sessions. Serve as coach for all Claims Examiners to handle problems and concerns as they arise. Review and recommends updates on policy and procedure critical to claims process. Perform other duties as assigned.Education Required Associate's DegreeIn lieu of degree, equivalent education and/or experience may be considered.Education Preferred Bachelor's Degree in Business Administration or Related FieldExperience Required:At least 4 years of claims processing and training and facilitation experience in a Managed Care environment with the demonstrated experience on the following list of stated knowledge and/ or skills. Extensive hands on experience in the design and delivery of training. Preferred: Supervisory experience Skills Required:Proficient using Word, Excel, and Access.  Knowledge of CA regulatory guidelines, Medi-Cal rules, CPT/ICD-10 coding, CMC lob. Excellent written and verbal communications skills Licenses/Certifications Required Licenses/Certifications Preferred Required Training Additional Information

Position Details

POSTED:

Nov 29, 2022

EMPLOYMENT:

INDUSTRY:

SNAPRECRUIT ID:

S16523280303243159

LOCATION:

United States

CITY:

Los Angeles, CA

Job Origin:

OORWIN_ORGANIC_FEED

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Aug 19, 2017 9am-6pm
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Claims Training Specialist II    Apply

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Job Summary The Claims Training Specialist II is primarily responsible for designing and conducting training programs using established departmental guidelines. This position is responsible for providing ongoing training on the core processing system, claims processing procedures, communicating regulatory changes which will affect established procedures, establishing quality and performance guidelines, creating and maintaining departmental policy and procedures, and working with the Claims Compliance Manager to monitor and track individual performance. Duties Build competencies for the Claims Department by designing and conducting training programs that will boost employee’s workplace performance in alliance with Enterprise and departmental goals. Responsible for performing training needs assessments with the Claims Compliance Manage and will assist in designing and delivering curriculum and learning materials to ensure the success of new and current Claims Examiners.  Work with document specialists to create training presentations and with Human Resource to customize training for inclusion into the L.A Care University.  Quality review of processed claims. Develop and create reports to determine area of improvement in claims processing for department.  Researching provider and member grievances to identify error trends and training opportunities. Create and develop tracking and trending mechanisms to identify type of grievances/ complaints for Claims Department. Conduct assessments after training to measure, record, and report feedback on training material and sessions. Serve as coach for all Claims Examiners to handle problems and concerns as they arise. Review and recommends updates on policy and procedure critical to claims process. Perform other duties as assigned.Education Required Associate's DegreeIn lieu of degree, equivalent education and/or experience may be considered.Education Preferred Bachelor's Degree in Business Administration or Related FieldExperience Required:At least 4 years of claims processing and training and facilitation experience in a Managed Care environment with the demonstrated experience on the following list of stated knowledge and/ or skills. Extensive hands on experience in the design and delivery of training. Preferred: Supervisory experience Skills Required:Proficient using Word, Excel, and Access.  Knowledge of CA regulatory guidelines, Medi-Cal rules, CPT/ICD-10 coding, CMC lob. Excellent written and verbal communications skills Licenses/Certifications Required Licenses/Certifications Preferred Required Training Additional Information


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