Claims Supervisor and Trainer

People are the most important asset of Imperial, for this reason the difference and plurality of people, equality of opportunities, non-discrimination and inclusion in the workplace are priority and strategic factors in the Organization. Imperial maintains a strong will to promote Diversity, Equity, and Inclusion, through inclusive leadership as a lever change and business sustainability.

Imperial Health Plan of California, Inc. is approved by California Department of Managed Health Care to offer full-service Medicare Advantage coverage, including a Medicare Advantage Prescription Drug plan, and a Chronic Condition Special needs plan over numerous counties in California. Through its affiliate, Imperial Insurance Companies, Imperial also offers Medicare Advantage plans in Texas, New Mexico, Utah, and Arizona.

THIS IS IN-OFFICE - NO REMOTE IS AVAILABLE

JOB SUMMARY:

Responsible for working collaboratively to provide education and development for new and existing operations staff. This includes development of recorded training content and maintaining current documented procedures for all workflows to ensure consistent and quality outputs in accordance with best practices. Will 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 JOB FUNCTIONS:

1. Build competencies for the Claims Department by designing and conducting training programs that will boost employee’s workplace performance in alliance with Enterprise and departmental goals.

2. Responsible for performing training needs assessments with the Claims Manager and will assist in designing and delivering curriculum and learning materials to ensure the success of new and current Claims Examiners.

3. Ensure that we have appropriate Business Rule documentation and/or presentations that allow examiners to completely understand processes in relation to claims processing.

4. Collaborating with our Quality Auditors to develop and create reports to determine area of improvement in claims processing for department.

5. Working collaboratively with Claims Managers/Auditing Supervisor, Compliance Supervisor, PDR Supervisor and Provider Relations and Customer Service in researching provider grievances to identify error trends and training opportunities.

6. Conduct assessments after training to measure, record, and report feedback on training material and sessions. Serve as coach for all Claims Examiners to handle problems and concerns as they arise.

EDUCATION/EXPERIENCE:

· Associates Degree. In lieu of degree, equivalent education and/or experience may be considered.

· 4 years in claims processing-medicare, medical-exchange-hospital and professional claims

· EZCAP experience is a plus

SKILLS/KNOWLEDGE/ABILITY:

· Advance knowledge of Microsoft Office, especially Word and Power point

· Demonstrated ability to be a self-starter, assertive, enthusiastic, and self-directed with excellent communication skills and customer-service orientation

· Exceptional organization skills and attention to detail; a high degree of ownership for projects, and strong follow-through

· Proven ability to work in a fast-paced, iterative cycle with multiple projects under scheduled deadlines

Job Type: Full-time

Pay: $42.00 - $46.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Referral program
• Retirement plan
• Vision insurance

Education:

• Bachelor's (Preferred)

Experience:

• Claims: 5 years (Required)
• Staff training: 1 year (Preferred)

Ability to Commute:

• Pasadena, CA 91106 (Required)

Work Location: In person

Salary : $42 - $46