Claims Process Trainer – Level 3
Role Purpose:
The primary responsibility of this role is to conduct comprehensive end-to-end claims process training for new hires and existing claims examiners.
Key Responsibilities:
1. Develop and deliver training programs on the complete claims process, including the basics of insurance, systems applications, policy wording interpretation, and claims assessment.
2. Create training materials, including presentations, manuals, and e-learning modules, to facilitate effective learning experiences.
3. Conduct orientation sessions for new hires to familiarize them with company policies, procedures, and the claims process.
4. Provide ongoing training and support to existing claims examiners to enhance their skills and knowledge.
5. Assess training needs and adapt training programs to meet the evolving requirements of the claims department.
6. Utilize various training methods, including classroom instruction, hands-on workshops, and online training platforms, to engage learners effectively.
7. Evaluate the effectiveness of training programs through feedback, assessments, and performance metrics, making improvements as necessary.
8. Stay current with industry trends, regulations, and best practices to ensure training content is relevant and up-to-date.
9. Collaborate with claims management and subject matter experts to ensure alignment of training with operational goals and standards.
10. Assist in the development and refinement of training programs, processes and tools.
11. Participate in regular team meetings and contribute to continuous improvement initiatives.
12. Support the Manager in special projects and initiatives as needed.
13. Conduct audits of claims during new hire training certification exams.
14. Prepare detailed reports on conducted trainings, including trends, challenges, issues and recommendations for improvement.
15. Foster a positive learning environment that encourages questions, discussions, and knowledge sharing.
Experience:
• Minimum of [3] years of experience in claims processing, auditing, or quality assurance within the insurance or healthcare industry.
• Proven experience in developing and delivering training programs, preferably in the insurance or financial services industry.
• Excellent presentation and communication skills, with the ability to convey complex information in an understandable manner.
• Strong organizational skills and attention to detail, with the ability to manage multiple training sessions and projects simultaneously.
• Proficient in using training software and tools, as well as Microsoft Office Suite (Excel, Word, PowerPoint).
• Ability to work independently and collaboratively in a team environment.
• Ability to develop and implement appropriate claims management strategies and plans.
• Sound knowledge of claims administration procedures and related systems.
Qualifications:
• Tertiary Qualified or minimum 3-4 years similar work experience