Claims Training & Operations Leader

Southeastrans, Inc.; Villa Rica (GA); On-site; USD 65,000 - 90,000; Full time

Job summary

Southeastrans, Inc. is seeking a Corporate Administrator to lead training and development for our Claims staff in Villa Rica, GA. You will partner with the Claims Manager to design and deliver training, document procedures, and support audits and client requests.

The role requires experience in claims processing, training program creation, and strong HIPAA compliance, with a focus on improving efficiency and operational excellence within the Claims Department.

Qualifications

• Minimum of 3 years of leadership experience
• Minimum of 5 years of claims processing experience preferred
• Minimum of 3 years of training experience preferred, with a focus on developing training programs and materials
• Must adhere to HIPAA standards
• Proficiency in using standard office equipment, including copiers, fax machines, phones, and computer hardware/software
• Demonstrates strong proficiency in Microsoft Excel
• Excellent written and verbal communication skills, capable of engaging effectively with executive management and staff
• Ability to formulate and modify policies, train, and direct staff in best practices
• Strong customer service focus and the ability to engage with a diverse group of internal and external customers
• Exceptional organizational skills, ability to focus on assigned tasks
• Able to work collaboratively, diplomatically, and with integrity in problem identification and problem-solving activities

Responsibilities

• Identify ways to improve employee efficiency and effectiveness.
• Oversees, trains, and evaluates the performance of staff, providing guidance and support as needed.
• Assist in processing claims when necessary.
• Supports State Directories and/or the Director of Internal Audits with state/clients’ audits.
• Manage the Telecommuter program, Claims Account Representative, and Claims Specialists II, ensuring adherence to department standards.
• Provide feedback on revisions to policies and procedures and on the development of work processes.
• Identify and investigate potential fraud.
• Demonstrates the ability to interpret and apply plan-specific contract provisions.
• Assist clients with complaints regarding billing submissions.
• Assist with projects, development of reports, and perform other program-related duties as assigned.
• Represent the organization at client meetings, professional association events, and workshops.
• Develop and maintain training materials including handbooks, demonstration models, multimedia visual aids, computer tutorials, and reference workshops.
• Partner with management to develop and execute scheduled specialized training sessions focused on system enhancements, workflow changes, new products or product changes, as well as policy/procedure changes.
• Conduct training needs analysis to determine specific training needs for department staff and evaluate effectiveness of the training.
• Audit work and coordinate training initiatives to identify, develop, and publish corrective actions and educational materials.
• Perform other duties as assigned.

Skills

Leadership

Training design

Communication

Customer service

Organizational skills

Problem solving

Education

Bachelor's Degree in Business or related field

Tools

Microsoft Excel

Job description

Southeastrans, Inc. is seeking a Corporate Administrator to lead training and development for our Claims staff in Villa Rica, GA. You will partner with the Claims Manager to design and deliver training, document procedures, and support audits and client requests.

The role requires experience in claims processing, training program creation, and strong HIPAA compliance, with a focus on improving efficiency and operational excellence within the Claims Department.