Claims Trainer & Quality Assurance Specialist

    • Job Tracking ID: 828621
    • Job Location: Remote, USA
    • Job Level: Mid Career (2+ years)
    • Level of Education: High School/GED
    • Job Type: Full-Time/Regular
    • Date Updated: September 26, 2022
    • Years of Experience: 2 - 5 Years
    • Starting Date: ASAP
    • Salary Type:: Hourly
    • Rate:: 18.24 + DOE
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Job Description:

The Claims Trainer and Quality Assurance Coordinator Specialist is responsible for creating and implementing the Claims training program, and for assessing the quality and performance of our claims processors who handle our members’ and providers’ claims. This role performs in-depth claim audits to ensure accuracy in following the employers’ summary plan descriptions. This role assists with ongoing claims training, document development plans, and support the processors with their questions when the lead is unavailable.

Key Functions

  • Facilitates in person or remote classroom training for new hires.
  • Develops, organizes, and maintains training manuals.
  • Assists in the evaluation of training program and ongoing inter-department training.
  • Facilitates new hire audits and continual training support for all claim’s processors.
  • Performs routine audits and coaching with processors and leads to complete claims with accuracy and provides feedback for continual improvement.
  • Performs individual coaching to processors to ensure correction and prevent loss in quality claims.
  • Collects and reviews opportunities identified by Claims Leads, Claims Integrity Specialist and external auditors.
  • Participates in design of quality standards.

Experience and Skills:

  • High school degree, or equivalent.
  • 3-5 years’ experience in Claims.
  • Proficiency with Microsoft Office products.
  • Demonstrated excellent attendance and punctuality.
  • Strong verbal and written communication skills.

Preferred Qualifications

  • Knowledge of medical and dental terminology.
  • GBAS experience.
  • Ability to handle pressure situations, personnel, and management.
  • Excellent attitude and professionalism.

AmeriBen is not yet hiring in the below locations:

  • Delaware, Massachusetts, New Hampshire, New York, North Dakota, Rhode Island, Vermont, District of Columbia and Puerto Rico.

AmeriBen is an Equal Opportunity/Affirmative Action Employer committed to creating an environment of diversity and inclusion for equal employment and advancement opportunities to all employees and applicants for employment. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, national origin, sex, sexual orientation, gender identity and/or expression, genetic information, disability, veteran or military status, or any other category protected by federal, state and/or local law.

If you are unable to use our online application process due to a disability, please contact the Human Resources Department at humanresources@ameriben.com .