Claims Processor Trainer

4 weeks ago

Makati, Philippines ImageNetLLC Full time

Job Title

Claims Processor Trainer – NON-VOICE

In-Office Training Now, Potential for Remote Work Later

Overview

Position Summary: We are seeking a knowledgeable and experienced Trainer for the Claims Adjudication Process to join our growing team. The ideal candidate is responsible for designing, facilitating, and evaluating training programs focused on claims processing, adjudication policies, compliance standards, and system workflows. This role is crucial in equipping new hires and existing staff with the skills and knowledge needed to ensure accuracy, efficiency, and compliance in claims handling.

Responsibilities
  • Develop and deliver comprehensive training modules on the end-to-end claims adjudication process.
  • Facilitate onboarding sessions for new hires specific to healthcare or insurance claims workflows.
  • Conduct refresher training, upskilling, and process updates for tenured staff.
  • Create training materials such as guides, job aids, SOPs, and e-learning content.
  • Ensure trainees understand key concepts such as eligibility verification, benefit determination, coding, billing practices, denial management, and compliance regulations.
  • Evaluate training effectiveness through assessments, feedback, and on-the-job performance metrics.
  • Partner with subject matter experts (SMEs), Operations, and QA teams to maintain process alignment.
  • Keep updated on changes in healthcare/insurance guidelines, payer requirements, and adjudication systems.
Qualifications
  • Bachelor’s degree (Administration, Business, or related field) preferred.
  • At least 5 years of experience as a Trainer for Claims Adjudication, preferably in a BPO or insurance setting.
  • Deep understanding of healthcare/insurance claims lifecycle, policies, and adjudication logic.
  • Excellent communication, facilitation, and presentation skills.
  • Proficiency in MS Office and familiarity with claims processing platforms (e.g., Facets, Amisys, Xcelys, EZ-Cap tool) is a plus.
  • Knowledge of HIPAA, CMS, or other relevant regulations is an advantage.
Requirements & Work Arrangement
  • Work Setup: Initially onsite in Makati City. Remote work is available post-training based on performance and business needs.
  • Working Hours: Night shift; must be flexible to work holidays and weekends if required.
  • Internet Requirements: A minimum of 25 Mbps download / 5 Mbps upload is required and must be hardwired.
  • Work Environment: A quiet, dedicated workspace is required.
Additional Benefits
  • Day 1 HMO (Medical and Dental Coverage) with 1 Free Dependent
  • Transportation/Internet allowance
  • Equipment provided
Company Overview

Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans’ members and providers.

The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans’ members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients.

Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines.

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