Job ID# 1008832 – Posted 2/24/2023 – Los Angeles, CA

The Claims Training Specialist is primarily responsible for designing and conducting training programs using established departmental guidelines. This position is responsible for providing ongoing training on the core processing system, claims processing procedures, communicating regulatory changes which will affect established procedures, establishing quality and performance guidelines, creating and maintaining departmental policy and procedures, and working with the Claims Compliance Manager to monitor and track individual performance.

– Knowledge of CA regulatory guidelines, Medi-Cal rules, CPT/ICD-10 coding, CMC lob.

– At least 4 years of claims processing and training and facilitation experience in a Managed Care environment
– Working with Medical Claims Experience
– Medicaid, Medical Claims Experience
– Extensive hands on experience in the design and delivery of training
– Supervisory Experience

Associate’s Degree

Please send your resume and any additional information to our recruitment team at recruitment@nexlogica.com