Job purpose

Customer service support for third party administrators, Health Maintenance organizations, preferred provider organizations, managed care organizations and many more in US healthcare insurance market by identifying and updating information.

The ultimate motive is to ensure commendable service standards and maintain very high customer satisfaction.

Duties and responsibilities

Listed below are the primary job duties and responsibilities that are required:

• US Healthcare experience required at expert level
• Strong in presentation/delivery of training to both live as well as virtual audience. Should be confident in talking to people (stand-up communication to be specific)
• Should be comfortable working in a 24*7 rotational shifts
• Responsible for end-to-end training of the account/process – right from the time a new hire joins Mphasis till he/she is active in the company i.e., new hire training + production/ ongoing trainings
• Should have handled and verified documents before paying/denying claims
• Installing and administrating healthcare provider contracts (hospitals, medical practices), including structure and billing set up, eligibility collection, database loading, and preparation of plan materials such as administrative documents and provider education materials
• Knowledge in healthcare Plan building is preferred
• Familiarity of Healthcare laws and legislative including the HIPAA (Health Insurance Portability and Accountability Act)
• Monitor, analyze and evaluate the effectiveness of training according to program goals. Identify knowledge and skill gaps by utilizing needs assessments and evaluation tools.
• Assist in developing training materials/SOPs (standard operating procedures) by working with claims staff as well as Team members from other departments within the organization, to develop training materials to improve existing training resources.
• Experience in developing desktop procedures and effective training materials in multiple formats PowerPoint presentations, job aids, practice activities and evaluations.

Experience and Skills requirement for this role:

• Minimum 4 to 5 years of experience in US Healthcare Claims Adjudications
• Should be good with MS Office and training reporting
• Team / People management
• Prior experience on Training Content Development using tools
• Working in permanent US shifts.

Qualifications

Qualifications include:

• Graduation in any discipline is a must
• Excellent communication and interpersonal skills.
• Ability to train and develop resources.
• Ability to work in a team, resolve conflicts, and the ability to work independently.

Skills

PRIMARY COMPETENCY : Training/Process Training

PRIMARY SKILL : Manager – Training

PRIMARY SKILL PERCENTAGE : 100.