Trainer - Claims Adjudication

Responsibilities :

• Conducting multiple trainings for new hires and managed nesting along with certification process.
• Experience in claims adjudication and payment integrity : Seeking individuals with expertise in claims adjudication and payment integrity, including overpayment and underpayment scenarios.
• Maintain the training effectiveness above the required threshold by holding strong governance process in training
• Ability to read through various standard operating procedures and communicate the extracts to the trainees clearly
• Identify gaps between internal process and customers’ expectations to help business produce the desired outcome
• Create content / training material for effective training
• Revamp the training materials to suit the need of current business and easy understanding / knowledge transfer to trainees
• Liaison with QA to calibrate process knowledge
• Conduct workshops for project team members on recent update and US healthcare industry trends
• Perform user acceptance testing for any new process rollouts / automation in the program
• Provides refresher training for bottom quartile
• Support the team by performing floor trouble shooting to ensure all relevant queries are tracked and answered appropriately
• Periodic knowledge calibration with client

Qualification & Experience

Critical :

Desirable :

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