Claims Trainer

ApolloMed is looking for a Claims Trainer who will work at 1600 Corporate Center Drive, Monterey Park, CA 91754 with the option to be hybrid.

ApolloMed (NASDAQ: AMEH) is a technology-powered healthcare management company building and operating a value-based healthcare delivery platform to provide the highest quality of care for their patients in a cost-effective manner.

Under the general direction of the Director of Claims Operations, Director of Operations and/or the Claims Compliance Manager/s, the Claims Trainer is responsible for working collaboratively to provide education and development for new and existing operations staff. This includes development of recorded training content and maintaining current documented procedures for all workflows to ensure consistent and quality outputs in accordance with best practices. The Claims Trainer will coordinate, plan, prepare, schedule, deliver, and evaluate staff education, manuals, and materials. Assist with the orientation, education and integration of new employees in the Claims Department.

CORE RESPONSIBILITIES

Note: Other responsibilities may be assigned. To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Build competencies for the Claims Department by designing and conducting training programs that will boost employee’s workplace performance in alliance with Enterprise and departmental goals.

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  Responsible for performing training needs assessments with the Claims Compliance Manager and will assist in designing and delivering curriculum and learning materials to ensure the success of new and current Claims Examiners
  
• Ensure that we have appropriate documentation and/or presentations that allow examiners to completely understand processes in relation to claims processing.

• Collaborating with our Quality Auditors to develop and create reports to determine area of improvement in claims processing for department.

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  Working collaboratively with Claims Managers/Supervisors, PDR Supervisor, Provider Relations and Customer Service in researching provider grievances to identify error trends and training opportunities.

• Conduct assessments after training to measure, record, and report feedback on training material and sessions. Serve as coach for all Claims Examiners to handle problems and concerns as they arise.

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  Review and recommends updates on policy and procedure critical to claims process.

REQUIRED QUALIFICATIONS

• Associate's Degree
• In lieu of degree, equivalent education and/or experience may be considered.
• 4+ years in claims processing
• EZCAP is a plus
• Advance knowledge of Microsoft Office, especially Word and Powerpoint
• An equivalent combination of education, certification, training, and/or professional experience may be used to meet the minimum education qualifications

PREFERRED QUALIFICATIONS

• Demonstrated ability to be a self-starter, assertive, enthusiastic, and self-directed with excellent communication skills and customer-service orientation
• Exceptional organization skills and attention to detail; a high degree of ownership for projects, and strong follow-through
• Proven ability to work in a fast-paced, iterative cycle with multiple projects under scheduled deadlines
• Demonstrated ability to understand and explain issues from both a technical and a business functional point of view
• Experience working with customers and collaborating on solutions
• Quality oriented, innovative, analytical, steadfast, and efficient

BENEFITS

As per NMM Employee Handbook, which may change from time to time, not all employee classifications are eligible to receive company benefits.

• Medical/Dental/Vision/Basic Life Insurance and AD&D
• 401k match up to 2% for first 5% contributed
• Flexible Spending Account
• Starting at 15 Days of Paid Time Off and 9 Holidays
• Tuition Reimbursement
• And more!

ABOUT US

What is value-based care? It is healthcare that focuses on quality of care rather than quantity of care. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient outcomes, increase access to healthcare, and make the US healthcare system more efficient for our members.

Our platform currently empowers over 7,000 physicians to provide care for over 1.2 million patients nationwide. Our rapid growth and unique position at the intersection of all major healthcare stakeholders (payer, provider, and patient) gives us an unparalleled opportunity.

EQUAL EMPLOYMENT OPPORTUNITY COMMISSION

ApolloMed Holding Inc., including Network Medical Management and all subsidiaries provide equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.