Claims Adjudication Trainer

Summary

Job Description

The Claims Adjudication Trainer is responsible for providing comprehensive training and support to new and existing Claims Examiners, Adjusters, and Auditors, monitor trainee production and performance, and adhere to MPM’s policies and regulations. The Claims Adjudication Trainer will report to the Supervisor of Claims Audit and Adjudication.

Duties And Responsibilities

• Create, update, and maintain training materials, including SOPs, Job Aids, and other tools.
• Lead training sessions to onboard new claims examiners and provide ongoing training to current staff.
• Regularly assess the effectiveness of training programs and adjust them to meet the needs of both new hires and seasoned teammates.
• Providing feedback, review performance metrics and identify areas of improvement.
• Ensure Examiners, Adjusters, & Auditors understand claims adjudication, business rules and key regulations.
• Provide ongoing support to the Examiners, Adjusters, & Auditors.
• Collaborate with Claims Leadership to identify any trends or gaps in knowledge that need to be addressed in training programs.
• Keep up to date with changes in the processes and share relevant updates with the team.
• Maintain uniformity in training across different teams and ensure all Examiners, Adjusters, & Auditors operate in line with company policies and standards.
• Maintain detailed records of attended training sessions, progress and competencies achieved.
• Provide regular reports to leadership on training progress, challenges, and success to highlight the effectiveness of the training session and its impact on claims performance.
  
  

Minimum Job Requirements

• HS diploma/GED
• Advanced knowledge of all LOBs and Claims Adjudication
• Proficient in all tools used by the Claims Dept.
• Minimum 4 years of Claims Examiner/Auditor Experience
  
  

Skill And Abilities

• Organized
• Efficient
• Strong verbal and written communication
• Ability to work with other MPM teams
• Team Player