Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota???s leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs. UCare is growing in size, membership, products, geographic coverage, and employees. We???re an organization that???s going places. Be part of a team that cares about you, be part of UCare.
As the Claims Trainer, you will develop and implement core training programs and resources for the Claims Department staff as well as deliver and provide feedback on performance and additional training needs for new employees. Develop, monitor, and maintain the Claims Department policies and procedures in compliance with all regulatory requirements. Assist with the development and presentation of UCare sponsored training programs. Provide technical assistance including: test new configurations in demo and production environments, test new installation or upgrades in software, research, and assist in documentation used to training and department policies and procedures.
- Develop, maintain, implement and audit core training curriculum and materials; in collaboration with managers and supervisors. Iidentify knowledge gaps as well as opportunities to enhance processor performance through additional training to ensure timely and accurate delivery of training programs for new and existing claims staff including conducting cross-training.
- Serve as internal and external department resource and contact for questions regarding complex claim issues that require processing or testing to accuracy.
- Work with the Claims Department management team to implement policies and procedures. Develop training, as appropriate, to educate staff on new or revised policies and procedures.
- Assist in identifying and recommending changes to enhance Claims processing functions. Maintain and distribute updates to the Hospital and Nursing Home pricing grid and other claims processing tools.
- Understand and accurately interpret health plan member certificates of coverage, provider contracts, state and federal rules and regulations, UCare policies and procedures.
- In collaboration with various UCare departments and committees, participate in the analysis, development, and delivery of training programs for UCare staff.
- Build, design, and stress/break test scenarios in demo to determine if new installation will perform as expected prior to moving into production environment. Retro testing may need done to ensure new installation did not effect other areas of the system.
- Track actual results vs expected results and Make recommendations to install or continue further testing.
- Run and analyze Query reports from Amisys and Macess.
- Maintain and update Amisys system letters.
- Perform other projects and duties as assigned.
Two-year Associates degree preferred with course work in medical terminology, CPT-4 and ICD-9 coding required. Preferred professional training certification. Relevant work experience will be considered in lieu of a two-year degree.
Minimum of five years experience in Medicare, Medicaid, HMO and/or indemnity claims processing, CPT and ICD-9 coding and medical terminology required. Experience with training and/or system development, testing methodologies, and ability to perform analysis. Detail oriented with strong analytical and data entry skills. Demonstrated experience with Access and Excel. General knowledge of DHS and CMS claims processing guidelines.
Knowledge of Medicaid, General Assistance, Medical Assistance, Minnesota Care and Medicare helpful. Previous Amisys Claims System and MACESS Exp experience a plus.
Knowledge, Skills, and Abilities
- Knowledge of adult learning styles and principles.
- Demonstrated training and facilitator experience.
Ability to present to different target audiences.
Excellent oral and written communication skills.
Excellent interpersonal communication skills.
Demonstrated organizational and time management skills, with a highly developed ability to prioritize.
Ability to identify and resolve problems.
Data analysis skills.
Ability to maintain confidentiality in all circumstances.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You???ll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis???just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.