Senior Trainer

Overview

Med-Metrix, Pasig, National Capital Region, Philippines

Senior Trainer - AR at Med-Metrix

Job Purpose: The Senior Trainer is responsible for conducting medical billing, claim denials & appeals, revenue cycle management training programs for new and existing forensic billers. Performs actual medical billing & claim denials work for existing accounts on a regular basis to keep an up-to-date knowledge of the process. Participates in process implementation during account take offs or go-live.

• Develops curriculum, training syllabus, and course modules related to Medical Billing (US Health Insurance, Claims Process, Denials & Appeals, Revenue Cycle Management)
• Develops Basic Account Navigation Workflow of Billing System for both HP and PB (Epic, Athena) and other system tools (Encoder Pro, CCI Edit) used by the department
• Develops Denials Process workflow for Common Denials (Duplicate, Timely Filing, No Prior-Auth, Medical Necessity, etc.)
• Develops a guideline for common Payer Policies for the Top US Health Insurance Payers (Aetna, BCBS, Humana, UHC, Cigna, etc.)
• Update and improve existing training and process modules
• Coordinate with forensic quality department to identify areas for process improvement and produce materials for claim edits, denials workflow, systems & process training from client
• Develops and produces materials for Medical Billing, Denials, Systems and Process exercises and qualifying examinations
• Updates weekly deck (performance and attendance for training meeting)
• Participates in weekly training meetings with the upper management
• Collaborates with billing operations managers, supervisors, and quality to resolve issues that impact internal and external customers
• Develops and conducts Call/Phone Handling Training for the new hires and existing forensic billers
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
• Understand and comply with Information Security and HIPAA policies and procedures at all times
• Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties

• Previous training work experience of at least 2 years
• Minimum of 2 years of medical billing or revenue cycle management experience specific to AR and Denials Management or provider side of the healthcare insurance industry
• In-depth understanding of claim denials
• CPB and Coding Certification (CPC, CCS, COC) is an advantage
• Supervisory experience preferred; demonstrated leadership skills
• Willingness and flexibility to work extended hours
• Knowledge of general computer applications and ability to multitask on two monitors. Proficient with Microsoft Office products
• Ability to work in a team fostered environment and have the willingness to adjust to changing job responsibilities, shifting schedules, new procedures and unexpected workloads and stresses
• Possess strong verbal, written communication, interpersonal and analytical skills
• Assertive self-starter who can work independently, yet function in a team environment
• Ability to plan well and prioritize work and maintain calmness under pressure
• Good interpersonal and other training soft skills
• An understanding and strict adherence to all HIPAA regulations

• Work Set-Up: Onsite
• Work Schedule: US hours, night shift; must be flexible to accommodate business needs
• Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
• Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
• Work Environment: The noise level in the work environment is usually minimal.