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Claims Trainer

Company: Christus Health
Location: Irving
Posted on: May 12, 2022

Job Description:

Summary:Under the supervision of the Claims Department Manager, this position is responsible for balancing workloads, assisting with establishment of structure and standardization, creation and updating of departmental policies and process and implementation and maintenance of oversight within the Claims Department. Monitoring of claim processing production and quality are required. Improvement initiatives in increasing claims auto adjudication will be performed. Additional functions of this role are supervising overall claim inventory, resolving escalated claim issues and assisting Claims Examiners with policy, regulatory or contractual questions and concerns. This position also will assist in audit related decision making and in training new Claims Examiners on job-specific roles and responsibilities.Assists in training new Claims Examiners on job specific roles and responsibilitiesMeet and/ or exceed claims processing production requirementsMaintain statistical accuracy of 97%, and financial accuracy of 98%Correct DoD error report as neededProvide excellent customer service to internal and external customersOther duties as assigned by managementCollaborate with and maintain open communication with all departments within CHRISTUS Health to ensure effective and efficient workflow and facilitate completion of tasks/goalsFollow the CHRISTUS Guidelines related to the Health Insurance Portability and Accountability Act (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI)Requirements:Analytic ability to organize and prioritize work to meet deadlinesAbility to organize and prioritize work to meet deadlinesStrong computer application skills including Microsoft Word, Excel and VisioExcellent written and verbal communication skills requiredGood judgment, initiative and problem solving abilitiesAbility to handle and resolve complex issues independentlyKnowledge of Medicaid, Medicare Advantage, Tricare and Health Care Exchange programs preferredKnowledge of claims processing, system configuration, edits, adjustment adjudication and claim department processesKnowledge of CPT/HCPCS, ICD-10 coding and medical terminology.Ability to learn new policies and processes based on written material and observationAbility to establish and maintain professional, positive and effective work relationships2 years Healthcare experience with Managed Care experience requiredPrior Claim Team Management experience preferredThree years claims processing experience required with Managed Care experience preferredClaim system configuration experience preferredPrior experience working with TRICARE, Texas Medicaid, Medicare Advantage highly desirable.Work Type:Full TimeWork Schedule/Shift5 DAYS - 8 HOURSReq. No21965Job TitleClaims TrainerMarketCHRISTUS System OfficeCategoryGeneral OperationsFacilityCHRISTUS Corp Irving Offices 919 and 909 BuildingsAddress919 Hidden RidgeIrving, TX 75038USView On A MapView Other LocationsTypeFULL TIME

Keywords: Christus Health, Irving , Claims Trainer, Human Resources , Irving, Texas

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