Trainer- Health Claims

5 days ago

Gurgaon, India Synergy plus business group consultant Full time

**Greetings from Synergy plus business consulting group.**

**We are looking for a Trainer from the health insurance domain**

**Key Responsibilities of trainer**
- Conducting new hire training as per the client guidelines
- Evaluating the outcome of training sessions
- Maintaining an up-to-date and accurate record of trainee progress and achievements
- Overseeing and monitoring training costs against budgets
- Ensuring that the organization’s resources are efficiently utilized
- Communicating the correct information and handling any questions from trainees
- Laying good examples by demonstrating the skills that are being taught
- Critically examining the trainees’ understanding and progress and making necessary adjustments to the program
- Scheduling training/refresher sessions to minimize disruption to normal working
- Strong verbal and written communication and interpersonal skills to understand problems, convey ideas and conduct training, and all of these are carried out through words
- Creative and innovative thinking, enables the employee trainer to keep things fresh to hold trainees’ attention, and also improvise on their teaching style
- Excellent presentation skills to present and handle training programs effectively
- Well-developed administrative skills, as an employee trainer is required to manage training programs efficiently, including identifying and bridging knowledge gaps

**Responsibilities for insurance claims**:

- Ensure timely and accurate adjudication of claims
- Take ownership of all claims processing issues and query management
- Manage all types of investigative activity on major claims
- Establishes claim reserve requirements and makes adjustments, as necessary, during the processing of the claims
- Investigate & resolve Health Claims
- Provide status updates and correspond with customer upon receipt and then the resolution of claims
- Ensure accuracy, timeliness, and consistency of claims reserves and payments
- Establish an overall budget and staff management, claims handling policies, programs, and annual business goals, and implement knowledge assessment, response strategy, and reporting process
- Review claims to determine coverage

**Qualifications for insurance claims**:

- **Experience in Health Insurance Domain, especially claims adjudication**
- **Prior experience of taking training of large groups - 20+ trainees**
- **Claim Preparation and Submission (including verification of service delivery, proper use of CPT codes, understanding of ICD-9 and ICD-10 codes, accurate data entry)**
- **Payments & Denials**
- **Effective and professional communication skills, including both written and verbal**
- **Uncover process discrepancies**

**Salary**: Up to ₹600,000.00 per year

Schedule:

- Day shift

Ability to commute/relocate:

- Gurgaon - 122002, Haryana: Reliably commute or planning to relocate before starting work (required)

Application Question(s):

- What is your current CTC and Notice period?(required)

**Experience**:

- Trainer
- health insurance: 2 years (required)

**Speak with the employer**

+91-XXXXXXXXXX

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