The role of the Training Specialist is to provide support to the Out of Network Service department by taking charge of the department’s training. This entails leading the onboarding process for new associates and overseeing ongoing training initiatives.
- Reviews and assesses the current state of the existing resources and makes recommendations to enhance those resources and/or generate new resources that will enhance the performance of the department associates.
- Identifies process improvements and learning opportunities based upon learning environment and departmental observations.
- Review results of quality assurance program and makes adjustments that also drive associate performance.
- Works in coordination with CCS Learning Services to ensure that programs align to divisional goals as well as collaborate to share resources and best practices where appropriate.
- Leads monthly, on-going training and development sessions with members of the Out of Network Service teams.
- Documents existing processes and policies within the departmental and regularly review and update those resources to ensure that they are consistently up to date.
- Retains responsibility for providing specific SOP training materials and guiding staff through SOP implementations.
- Ensures that all training and documentation adheres to Zelis standards regarding privacy, compliance, legal aspects, and HIPAA standards.
- Performs other related responsibilities as assigned.
- Five years or more experience in healthcare claim negotiations or medical claims processing
- Demonstrated success in a medical claims contract negotiations setting
- Knowledge of the full Microsoft Office Suite of products to include, but not limited to, MS Outlook, MS Word, MS Excel, and MS PowerPoint
- A background in medical claims processing, provider billing, medical claim coding is beneficial.
- Bachelor's degree in a related field or equivalent work experience
- Minimum of 3 years of experience in medical claims processing, with a deep understanding of claims adjudication processes and guidelines
- Prior experience in training or coaching, with a proven track record of successful training outcomes
As a leading payments company in healthcare, we guide, price, explain, and pay for care on behalf of insurers and their members. We’re Zelis in our pursuit to align the interests of payers, providers, and consumers to deliver a better financial experience and more affordable, transparent care for all. We partner with more than 700 payers, including the top-5 national health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, over 4 million providers, and 100 million members, enabling the healthcare industry to pay for care, with care. Zelis brings adaptive technology, a deeply ingrained service culture, and a comprehensive navigation through adjudication and payment platform to manage the complete payment process.
Commitment to Diversity, Equity, Inclusion, and Belonging
At Zelis, we champion diversity, equity, inclusion, and belonging in all aspects of our operations. We embrace the power of diversity and create an environment where people can bring their authentic and best selves to work. We know that a sense of belonging is key not only to your success at Zelis, but also to your ability to bring your best each day.
Equal Employment Opportunity
Zelis is proud to be an equal opportunity employer. All applicants will receive consideration for employment without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
We encourage members of traditionally underrepresented communities to apply, even if you do not believe you 100% fit the qualifications of the position, including women, LGBTQIA people, people of color, and people with disabilities.
We are dedicated to ensuring our application process is accessible to all candidates. If you are a qualified individual with a disability or a disabled veteran and require a reasonable accommodation with any part of the application and/or interview process, please email TalentAcquisition@zelis.com
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