Work collaboratively with department leadership to identify staff training needs. Plan and/or deliver continued education to department staff. Develop and maintain training materials that support the ability to process claims which meet or exceed accuracy and production standards. Create, update and maintain all department policies, procedures, and desktop instructions. Analyze data and produce accurate and timely productivity, quality and statistical reports for the department manager. Work with Facets Business Support staff to identify and resolve workflow and claims processing issues in Facets. Assist in high-level claims processing or adjustment processing in times of critical need and/or when training duties are up-to-date.
Work Experience: Minimum of three years’ health insurance or related experience required. Requires strong written documentation skills necessary to produce clear and concise department documentation and training materials. Must have the ability to develop and deliver appropriate training based presentations to department staff. Claims processing skills equal to or exceeding that of a Claims Analyst III are desired.
Education, Certificates, Licenses: High school diploma or equivalent required. Previous instruction or experience training others is preferred.
Knowledge: Requires experience with, and detailed knowledge and understanding of Facets claims processing and department workflow. Ability to use training techniques that address a variety of learning styles and personalities. Ability to understand and interpret PacificSource contract provisions applicable to the expanded service area. Average to advanced skills in Microsoft PowerPoint, Excel, Word, Visio and Outlook. Intermediate level or above experience with ICD-10 and CPT coding, and medical terminology are required. Knowledge of government programs claims processing is helpful.
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.