Claims Processor – Trainer (Remote Options)

Position Summary/Position

Remote and telecommuting options are available. Must live within Southern California area.

Under the general supervision of the Learning Development Manager, the Claims Trainer will conduct training exercises, classes or structured activities for individuals of the Claims Training Program. In this role, the Claims Trainer is responsible for planning, implementing, and delivering claims processing training curriculum. Additional responsibilities include evaluating initial training and ongoing learning opportunities to achieve consistency, efficiency, and productivity among the trainees. Recommends, develops and implements modifications related to training activities, content and methodology based on needs of participants. Major Functions (Duties and Responsibilities)

1. Train new Claims Processors and existing staff to process and adjudicate claims in the IEHP’s system using various modes and settings, which may include:

a. Classroom training using PowerPoint Presentations, Adobe Captivate or other presentation methods.

b. Develop and maintain training programs for Team Members, as well as corresponding support documentation. Based on performance metrics, identify areas of opportunity and formulate work plans in concert with management objectives. Conducts training needs assessments.

c. Research effective training delivery, including traditional classroom training, group activity, self-paced and One-on-One sessions.

d. Analyze reports for the purpose of tracking and trending Team Member performance and identify opportunities for improvement.

2. Assist in developing training materials by working with Claims staff, as well as Team Members from other departments within the organization, to develop training materials to improve existing training resources.

3. Research and evaluate learning programs, trends, and practices in order to devise appropriate curriculum.

4. Explore opportunities to incorporate technologically advanced training software (Adobe Captivate), Web and computer-based programs to incorporate in the Claims training program.

5. Maintain documentation, including database updates, training agendas, sign-in sheets, etc. to demonstrate trainee compliance with department requirements.

6. Work with the Claims Management Team to monitor error trends, productivity, and quality standards program for all trainees and Claims staff. Experience Qualifications

A minimum of four (4) years of experience in examining and processing claims required. Medi-Cal and Medicare claims processing or auditing experience required. Preferred Experience

A minimum two years (2) experience in facilitating and coordinating training programs or adult education preferred. Training and policy writing experience preferred. Education Qualifications

High school diploma or GED required. Preferred Education

Bachelor’s Degree in Education, Instructional Design, Business or a related field is preferred. Professional Certification

ATD Master Trainer Certification preferred. Knowledge Requirement

Strong understanding of adult learning principles and ability to demonstrate in classroom situations. Advance knowledge of ICD-9 and CPT coding and general practices of claims processing. Prefer knowledge and experience with a capitated managed care environment. Skills Requirement

Skilled in group facilitation and managing effective discussion and dialogue to enhance the learning experience. Familiarity with MS Windows and Office Programs. Excellent communication and interpersonal skills, strong organizational skills. Abilities Requirement

Ability to conduct effective and engaging presentations in a variety of delivery settings. Professional demeanor. Commitment to Team Culture

The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization. Working Conditions

Word processing and data entry involving computer keyboard and screens, filing and copying of records and/or correspondence.

Starting Salary: $50,835 – $78,790

Pay rate will commensurate with experience

Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region. With a provider network of more than 6,000 and a team of more than 2,000 employees, IEHP provides quality, accessible healthcare services to more than 1.2 million members. And our mission and core values help guide us in the development of innovative programs and the creation of an award winning workplace. As the healthcare landscape is transformed, we’re ready to make a difference today and in the years to come. Join our Team and Make a Difference with us! IEHP offers a Competitive salary and a benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and retirement plan.