Claims Process Documentation, Training Specialist

Job not on LinkedIn

🔥 1 hour ago

🗽 New York – Remote

🗽 New York – Remote

💵 $75k - $80k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📚 Learning and Development

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

Apply Now

Find Similar Remote Jobs

Set Up Email Alert For New Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Centivo

WebsiteLinkedInAll Job Openings

201 - 500 employees

Founded 2017

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Centivo is an innovative health plan provider for self-funded employers that focuses on delivering high-quality healthcare at an affordable cost. The company believes in the power of primary care to improve health outcomes and reduce costs. Centivo offers plans with free primary care, no deductibles, and low, predictable copays, thereby encouraging members to utilize their health benefits without financial burden. The plans are curated to meet stringent price and quality standards, promoting a strong relationship with primary care providers and integrating virtual care options. Centivo's approach is designed to reduce overall medical expenses while enhancing the healthcare experience for both employers and employees.

📋 Description

• Develop, document, and maintain end-to-end claims business processes and workflows, ensuring clarity, accuracy, and usability for claims team members. • Test claims workflows in Javelina and HRP to confirm processes function as designed and align with system configuration. • Document all new claims processes step-by-step in Confluence for use by claims team members when adjudicating claims. • Ensure documentation follows instructional design principles, is written in execution order, and includes screenshots as appropriate. • Own and manage all existing claims process documentation in Confluence, (in addition to including creating new documentation) including editing existing content, archiving outdated materials, deleting obsolete content, etc. • Build and maintain an intuitive documentation structure and search taxonomy to ensure ease of use and accessibility. • Create training and reference materials for the Claims organization, including Processors, Auditors, Recovery Analysts (including NSA and Subrogation), Appeals. • Design and deliver specialty claims training as needed to support new processes, system changes, or operational initiatives. • As needed, support training and onboarding of Claims new hires. • Partner with POP, Core Platform, and PMO teams to ensure claims process documentation aligns with new hire training, system configuration, and operational standards. • Partner with POP as a subject matter expert to ensure claims process and adjudication content is accurate, providing quality review of new hire and enhanced training materials (including COB, adjustments, and corrected claims) and advising on the appropriate sequencing of content within new hire training. • As needed, support claims operations by processing claims to assist with workload coverage and inventory management.

🎯 Requirements

• 3 years’ experience working in Claims healthcare within a payer and/or TPA environment, with a strong understanding of medical claims processing and adjudication. • 3 years demonstrated experience writing clear, detailed process documentation and/or developing training materials for operational teams. • Experience testing workflows or processes within claims systems to ensure accuracy, functionality, and usability. • 3 years' experience conducting instructor-led and/or virtual training sessions, including onboarding and specialty training, for claims or healthcare operations teams. • Experience working within claims platforms such as Javelina and HRP, including navigating, testing, or supporting claims workflows. • Experience using HRP for claims processing is highly preferred. • Excellent written and verbal communication skills, with the ability to serve as a subject matter expert and partner effectively across cross-functional teams. • Highly organized with strong attention to detail, including experience managing and maintaining documentation repositories and training resources. • Strong understanding of instructional design principles and the ability to translate complex payer/TPA claims processes into easy-to-follow documentation and learning tools. • Strong interpersonal skills, establishing rapport and working well with others.

🏖️ Benefits

• Offers Equity • Offers Bonus