Auditor, Claims Training and Technical

About the position

HealthPartners is hiring a Claims Auditor. This role provides systems training and offers consulting expertise and support to all levels of Claims staff. They will perform audits, conduct certification, and provide performance feedback to all new and promoting employees using analytical, technical, and communications skills.

Responsibilities

• Plans, organizes and delivers claims training programs using diverse training methodologies and approaches for claims and administrative staff.
• Ensures new and promoting employees' technical competence to heighten production and quality standards.
• Prepares, conducts and analyzes user audits to improve and maximize system use.
• Identifies system and/or benefit errors and recommends process improvement changes.
• Shares audit results with all new and promoting employees on a 1:1 basis.
• Enters all audit results into the Claims audit tracking system for individual employee tracking, reporting and future trend analysis.
• Initiates the certification process for all levels of claim processing for new and promoting employees.
• Supports departmental and divisional teams through participation in appropriate meetings and projects.
• Serves as an internal consultant to managers and claims staff regarding procedural and system related processes.
• Maintains a current knowledge base and utilizes new training delivery techniques and practices.
• Promotes teamwork through the practice of Covey and CQI philosophy.
• Performs benefit interpretation to define and facilitate development of policies and procedures.
• Develops appropriate measurement techniques to measure progress and/or deficiencies.
• Makes suggestions for system improvements to enhance automation and accuracy.
• Performs additional duties, attends meetings and assumes projects as assigned.

Requirements

• BA/BS in training and organizational development, industrial relations, communications and two years claims experience in the administration of insurance benefits or Associate degree and four years of HP claims experience.
• One year experience in the design and delivery of training programs which includes some technical training.
• Experience using desktop publishing software such as Microsoft Word, Excel and PowerPoint.
• Experience working with HTML.
• Detailed knowledge of adult learning theories and methods of instruction.
• Detailed knowledge and understanding of the insurance industry including, claims processing and customer service expectations.
• Advanced analytical and problem solving skills.
• Effective presentation, planning and oral and written communication skills.
• Ability to interpret and explain provider and member/employer contracts.
• Ability to communicate at all levels of the organization and with external customers.
• Ability to handle and manage a high degree of change.
• Ability to work independently and as a team player.
• Ability to evaluate employee progress to ensure that the business needs of the department are being met.
• Familiarity with training equipment and materials.

Nice-to-haves

• Master’s degree in training and organizational development, industrial relations, communications, business administration or other relevant field.
• Three to five years full-time training experience in a hospital, ambulatory care, or insurance environment, including some technical training background.