Claims Trainer
$69,992–$83,990 year
On-siteRedding, California, United States or Fairfield, California, United States
Job Summary
Train examiner and customer service level I staff on all Partnership claim types using the AMISYS Advance system and Claims Operating Instruction Memorandums. Deliver on-site and regional training for CIF processing, adjustments, and system adjustments while creating and maintaining training materials. Provide feedback to the Claims Audit Supervisor and Associate Director of Claims regarding staff training needs and system updates. Maintain current knowledge of Partnership Claims Policy, Medi-Cal Provider Manual, Title 22 regulations, Knox Keene regulations, and CMS Medicare regulations. Draft Claims Operating Instruction documentation for the Claims Director as assigned. Assist with system testing as needed. Requires minimum two years of claims examining experience, proficiency with AMISYS or similar systems, and a valid California driver's license. Salary ranges from $33.65 to $40.38.
Required Qualifications
- Minimum two (2) years of claims examining experience
- Completion of Partnership Claims training
- Equivalent combination of education and experience
- Familiar with MediCal and/or managed care claims processing
- Knowledge of CPT, HCPC procedure coding, and ICD-9/ICD10 diagnostic coding
- Typing speed 30 wpm
- Proficient use of 10-key calculator
- Familiar with AMISYS or similar claims systems
- Understanding of claims examining requirements
- Valid California driver's license
- Proof of current automobile insurance compliant with Partnership policy
Desired Qualifications
- Excellent oral and written communication skills
- Ability to effectively exercise good judgment within scope of authority and handle sensitive issues with tact and diplomacy
- Ability to work on multiple tasks within established time frames and sometimes conflicting priorities
- Good organizational skills with ability to maintain accurate records and documentation of actions and decisions
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