Claims Process Documentation, Training Specialist

This is a fully remote position, open to applicants in New York.

📋 Description

• Develop, document, and sustain comprehensive end-to-end claims business processes and workflows, ensuring they are clear, accurate, and user-friendly for claims team members.

• Validate claims workflows in Javelina and HRP to ensure that processes function as intended and are in alignment with system configuration.

• Create detailed step-by-step documentation of new claims processes in Confluence for use by claims team members during claims adjudication.

• Ensure that documentation adheres to instructional design principles, is organized in execution order, and incorporates screenshots as necessary.

• Take ownership of and manage all existing claims process documentation in Confluence, which includes creating new documentation as well as editing, archiving outdated materials, and removing obsolete content.

• Establish and maintain an intuitive documentation structure and search taxonomy to guarantee ease of use and accessibility.

• Develop training and reference materials for the Claims organization, encompassing Processors, Auditors, Recovery Analysts (including NSA and Subrogation), and Appeals.

• Design and provide specialized claims training as required to support new processes, system updates, or operational initiatives.

• Support training and onboarding for new Claims hires as necessary.

• Collaborate with POP, Core Platform, and PMO teams to ensure that claims process documentation aligns with new hire training, system configurations, and operational standards.

• Act as a subject matter expert in partnership with POP to guarantee the accuracy of claims process and adjudication content, performing quality reviews of new hire and enhanced training materials (including COB, adjustments, and corrected claims) and advising on the appropriate sequencing of content within new hire training.

• Provide assistance to claims operations by processing claims to help manage workload and inventory as needed.

⛳️ Requirements

• Minimum of 3 years of experience in Claims healthcare within a payer and/or TPA environment, with a solid understanding of medical claims processing and adjudication.

• At least 3 years of demonstrated experience in writing clear, detailed process documentation and/or developing training materials for operational teams.

• Experience in testing workflows or processes within claims systems to ensure accuracy, functionality, and usability.

• A minimum of 3 years of experience conducting instructor-led and/or virtual training sessions, including onboarding and specialized training, for claims or healthcare operations teams.

• Familiarity with claims platforms such as Javelina and HRP, including navigation, testing, or supporting claims workflows.

• Experience with HRP for claims processing is highly preferred.

• Exceptional written and verbal communication skills, enabling effective partnership as a subject matter expert across cross-functional teams.

• Highly organized with a keen attention to detail, including experience in managing and maintaining documentation repositories and training resources.

• Strong understanding of instructional design principles and the ability to convert complex payer/TPA claims processes into easy-to-follow documentation and learning tools.

• Excellent interpersonal skills, capable of building rapport and collaborating effectively with others.

🏝️ Benefits

• Offers Equity

• Offers Bonus