The Claims Training Specialist reports directly to the Claims Manager. This position is responsible, for developing, managing and executing the new hire and continued educational training for claims examiners and other claims staff employees. The Claims Training Specialist is also responsible for coordinating with department leaders to document and implement processes and procedures.

Principal Duties and Responsibilities:

• Provides and delivers an effective training program to develop and grow the depth of knowledge, quality, and production level of the claims department to meet defined goals.
• Design and develop training materials, such as module summaries, agendas, outlines, videos, and testing, for various training initiatives to be used in a group, virtual and one-on-one trainings.
• Review, update and maintain claims processing training materials to ensure they remain up to date and consistent with claims best practices and industry standards.
• Maintain records of training activities, new hire onboarding, and auditing and communicates on employee progress.
• Perform and review claims audits for trainees.
• Coordinates with department leaders to document and implement processes and procedures & assess and execute ongoing departmental training needs.
• Maintains working knowledge of the claims process and related organizational processes impacting the claims process.
• Review of other applications used such as SharePoint, SDS, Employee Portals, etc.
• Process claims.
• Other duties as assigned.

General Expectations:

• Present a positive image of Consociate at all times.
• Provide and promote the delivery of services with a prevailing attitude of respect and recognition of the personal worth and dignity of every individual whether they are a client, coworker or supervisor.
• Communicate in a clear and concise manner, while also demonstrating receptivity through active listening.
• Identify and perform work that has not been specifically assigned, as needed.
• Adhere to established safety standards and utilizes proper techniques to avoid work-related injuries.
• Continuously seek opportunities for improvement and suggest ways in which procedures/systems may be modified to accomplish tasks/goals efficiently and effectively.
• Demonstrate a teamwork philosophy by working cooperatively with others inside and outside the Claims Division.
• Attend required in-service and staff meetings.
• Preserve the confidentiality of all business-sensitive information, including but not limited to that of insured groups and individuals and employees.
• Must have prior medical claims experience
• Medical coding experience a plus