Claims Administrator
On-siteVilla Rica, Georgia, United States
Job Summary
Create and deliver effective training programs for Claims staff, clients, and service providers while conducting training needs analyses and evaluating effectiveness. Oversee, train, and evaluate staff performance; manage the Telecommuter program, Claims Account Representative, and Claims Specialists II. Develop and document standard operating procedures, Claims policies, and training materials including handbooks and multimedia visual aids. Identify and investigate potential fraud; assist in processing claims, handling billing complaints, and coordinating audit responses. Represent the organization at client meetings and professional association events. Partner with management to execute specialized training sessions focused on system enhancements, workflow changes, and new products.
Required Qualifications
- Minimum of 3 years of leadership experience
- Must adhere to HIPAA standards
- Proficiency in using standard office equipment, including copiers, fax machines, phones, and computer hardware/software
- Demonstrates strong proficiency in Microsoft Excel
- Excellent written and verbal communication skills, capable of engaging effectively with executive management and staff
- Ability to formulate and modify policies, train, and direct staff in best practices
- Strong customer service focus and the ability to engage with a diverse group of internal and external customers
- Exceptional organizational skills, ability to focus on assigned tasks
- Able to work collaboratively, diplomatically, and with integrity in problem identification and problem-solving activities
- Bachelor's Degree in Business or related fields
- Must be able to travel occasionally
- Must have three years of training experience
- Must have three to five years of experience formulating training curricula
- Must have three to five years of experience using multimedia visual aids
Desired Qualifications
- Minimum of 5 years of claims processing experience preferred
- Minimum of 3 years of training experience preferred, with a focus on developing training programs and materials
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