Job Information

St. Joseph Health / Covenant Health Claims Trainer - Claims in Mission Hills, California

We are looking for a Claims Trainer with a $1,000 Sign-On Bonus for the Claims Department at Providence Medical Foundation. $1,000 Sign-On Bonus for eligible external candidates who meet all conditions for payment - this is in addition to the fantastic benefits and compensation package offered by Providence that begin on your first day of employment.

Location: Mission Hills, CA

Work Schedule: Full time - 80 Biweekly Hours

Shift: 8-hour, Days

Job Summary:

Working under the general supervision of the Claims Director, provide an effective education program to advance the quality and production level of the Claims Department by developing and delivery claims training programs that continuously improves the Claims Department performance to meet the NSS strategic goals. Coordinate, plan, prepare, schedule, deliver, and evaluate staff education, manuals, and materials. Assist with the orientation, education and integration of new employees in the Claims Department.

Essential Functions:

  • Conducts training classes for new hires and current staff members relative to the department’s training needs based on policies and procedures, compliance requirements, health plan products and NSS Operational objectives.

  • Conducts one-on-one training/coaching sessions with new hires and current staff members to ensure that department accuracy standards are met.

  • Creates and updates ancillary tools to assist in claims processing as well as, resolve inconsistencies between existing and updated processing guidelines.

  • Designs and maintains training/coaching documentation in order to effectively evaluate examiner adherence of processing guidelines.

  • Evaluates audit reports, PDR reports and refund logs to identify learning and development issues. Escalates findings to Claims Management team.

  • Manages the learning environment for classroom setup, systems setup, course materials, media and on-line learning.

  • Monitors, records and reports all training functions, including tracking and reporting training classes, participants and special projects.

  • Provides feedback to management on policy and procedure improvements.

Skills:

  • Advanced level technical knowledge of IDX Claims Systems.

  • Detail oriented excellent logical abilities and thought processes.

  • Ability to work with a minimum of supervision and be able to interface with all functions and at all levels within the organization.

  • Requires strong written and verbal communications skills to communicate effectively with individuals at all levels of the organization.

  • Must be able to work as a team player and have a professional demeanor.

  • Organization and prioritization skills.

  • Strong adult learning, facilitation and presentation skills.

  • Must be a self-starter and have the ability to work independently.

  • Must be able to effectively manage time, projects and resources.

Minimum Position Requirements:

Education: Bachelor's Degree

Experience: Any combination of experience or equivalent background:

  • 5 years experience of acquired in-depth technical knowledge of functional area i.e., claims operations, HMO products, industry claims processing procedures, contracts, billing and overall managed care processes, etc.

  • Proficiency and experience in using multimedia training resources and MS Office applications such as Word, PowerPoint and Excel, etc.

  • Experience in design, development and facilitation of educational programs in a corporate setting a plus. Ability to create computer-based learning programs a plus.

Providence Medical Foundation (formerly St. Joseph Heritage Health) includes seven medical groups throughout Northern California, Orange County, High Desert and Los Angeles County. With 175 locations and nearly 4,000 caregivers (employees), Providence Medical Foundation has been continually recognized as a leader in quality, receiving top honors from various organizations, including the Orange County Medical Association for Physicians of Excellence and the Integrated Healthcare Association with distinction in clinical quality. Providence Medical Foundation provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Providence Medical Foundation complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.

Company: Providence Medical Foundation

Category: Billing/ Insurance

Req ID: R356003