Claims Process & Training Specialist

Responsibilities Include:

• Develop, document, and maintain end-to-end claims business processes and workflows, ensuring clarity, accuracy, and usability for claims team members.

• Test claims workflows in Javelina and HRP to confirm processes function as designed and align with system configuration.

• Document all new claims processes step-by-step in Confluence for use by claims team members when adjudicating claims.

• Ensure documentation follows instructional design principles, is written in execution order, and includes screenshots as appropriate.

• Own and manage all existing claims process documentation in Confluence, (in addition to including creating new documentation) including editing existing content, archiving outdated materials, deleting obsolete content, etc.

• Build and maintain an intuitive documentation structure and search taxonomy to ensure ease of use and accessibility.

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

• Design and deliver specialty claims training as needed to support new processes, system changes, or operational initiatives.

• As needed, support training and onboarding of Claims new hires

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

• Partner with POP as a subject matter expert to ensure claims process and adjudication content is accurate, providing quality review 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.

• As needed, support claims operations by processing claims to assist with workload coverage and inventory management.

Qualifications:

• Excellent written and verbal communication skills, with the ability to serve as a subject matter expert and partner effectively across cross-functional teams.

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

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

• Strong interpersonal skills, establishing rapport and working well with others