Claims Trainer

Partnership HealthPlan of California • Fairfield, CA

3d • $33 - $39 • Onsite

About The Position

Train examiner and customer service level I staff on all related claim types for all Partnership lines of business using AMISYS Advance system and Claims Operating Instruction Memorandums.

Requirements

• Minimum two (2) years of claims examining experience and completion of Partnership Claims training; or equivalent combination of education the experience.
• Familiar with Medi0Cal and/or managed care claims processing.
• Knowledge of CPT, HCPC procedure coding, and ICD -9/ICD10 diagnostic coding.
• Typing speed 30 wpm and proficient use of 10-key calculator.
• Familiar with AMISYS or similar claims systems.
• Understanding of claims examining requirements.
• Valid California driver’s license and proof of current automobile insurance compliant with Partnerrship policy are required to operate a vehicle and travel for company business.
• Excellent oral and written communication skills.
• Ability to effectively exercise good judgment within scope of authority and handle sensitive issues with tact and diplomacy.
• Ability to work on multiple tasks within established time frames and sometimes conflicting priorities.
• Good organizational skills with ability to maintain accurate records and documentation of actions and decisions.
• Ability to use a computer keyboard.
• More than 60% of work time is spent in front of a computer monitor.
• When required, ability to move, carry or list objects of varying size, weighing up to 5 lbs.
• Provide the highest possible level of service to clients.
• Promote teamwork and cooperative effort among employees.
• Maintain safe practices.
• Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

Responsibilities

• Train all levels of staff on all claim types on-site or regional site(s).
• Train all levels of staff on CIF processing, generating and processing adjustments both on-site and regional site(s).
• Provide feedback and recommendation to the Claims Audit Supervisor and Associate Director of Claims on staff training needs and system adjustments.
• Create and maintain training materials.
• Maintain current knowledge of Partnerhsip Claims Policy and Procedures for all lines of business, Medi-Cal Provider Manual, Title 22 regulations, Knox Keene regulations, and CMS Medicare regulations.
• Draft Claims Operating Instruction documentation for the Claims Director as assigned.
• Assist with system testing as needed.
• Other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree