What are the responsibilities and job description for the Healthcare QA/Claims Auditor & Training Coordinator position at RJI Search?
Healthcare Claims Quality Coordinator & Trainer
Aurora, IL, US - onsite only once per quarter - remote otherwise
The Claims Trainer / Quality Coordinator will evaluate the Claims department workforce with the intent of enhancing professional learning and development. This position will assist management in ongoing and long-term employee auditing, training and development through classroom learning, one-on-one training and coaching as well as objective auditing delivered through standardized forms and verbal feedback.
ESSENTIAL JOB FUNCTIONS AND DUTIES
- Conducts QA analyses and processes reviews on healthcare claims processors
- The role is 75% Claims QA - 25% training processors
- Creates training materials such as guidelines and procedures for training and coaching
- Conducts role-specific training classes quarterly
- Coordinates with management to identify training and development opportunities
- Identifies and analyzes trends and provides insight to management regarding claims department efficiency
- Improves and ensures quality of claim handling practices
- Monitors and delivers feedback to management on the progress of training classes and coaching efforts
- Maintains quality and productivity standards through training and coaching
- Calculates weekly and monthly audit results
- Partners with other areas of the organization to coordinate training efforts and makes recommendations for improvement of interdepartmental business processes
- Provides support for claim resolution by gathering and communicating information to develop procedures for complex claim handling
- Set goals and achieve measurable results
ESSENTIAL QUALIFICATIONS
Salary range for this position : Actual base salary may vary based upon, but not limited to : relevant experience, qualifications, expertise, certifications, licenses, education or equivalent work experience, time in role, peer and market data, prior performance, business sector, and geographic location.
Work Schedule (may vary to meet business needs) : Monday~Friday, 7.5 hours per day (37.5 hours per week). Some office days required, but largely a work from home set up.
We reward great work with great benefits, including but not limited to : Medical (almost free), free Dental, free Vision, Paid Time-Off (PTO), Paid Holidays, 401(k) with match and Pension, Short- & Long-term Disability, Life, AD&D, Flexible Spending Accounts (healthcare & dependent care), Commuter Transit, Tuition Assistance, and Employee Assistance Program (EAP).
