Urgent! Customer Solution Center Appeals and Grievance Training Specialist Job Opening In Los Angeles California – Now Hiring Macpower Digital Assets Edge Private Limited
Job Summary:
The Customer Solutions Center Appeals and Grievances (A&G) Training Specialist II is primarily responsible for the overall training strategy across the department.
This position designs and conducts training programs using established regulatory and departmental guidelines.
This position is responsible for providing ongoing training on the core processing system, A&G processing procedures, training regulatory changes which will affect established procedures, working with the quality team on quality and performance guidelines, creating and maintaining departmental policy and procedures.
Additional responsibilities include evaluating initial training and ongoing learning opportunities to achieve consistency, efficiency, and productivity among the staff.
Duties:
Applies knowledge and skills to build competencies for the design of training programs that will boost employee's workplace performance in alliance with Enterprise and departmental goals.
Responsible for performing training needs assessments with the department management and will leads the design and delivery of curriculum and learning materials to ensure the success of new and current staff.
Conducts training for Customer Solution Center A&G team in customer service, product operations, and other work processes.
Conducts training sessions covering specified areas such as on-the-job training, use of computers and software, interpersonal skills, quality & process issues, and product knowledge.
Maintain documentation, including database/system updates, training agendas, sign-in sheets, etc.
to demonstrate trainee compliance with department requirements.
Work with key stakeholders to monitor error trends, productivity, and quality standards for the program.
Identifies gaps in knowledge, skills and abilities, assess and recommend training/education measures to resolve issues and enhance staff performance.
Propose program modifications to enhance performance and positively influence member satisfaction survey results.
Conduct assessments after training to measure, record, and report feedback on training material and sessions.
Serve as coach staff to handle problems and concerns as they arise.
Review and recommends updates on policy and procedure critical to claims process.
Perform other duties as assigned.
Required Skills, Experience & Qualifications:
Bachelor's Degree in Business Administration or Healthcare Related Field.
In lieu of degree, equivalent education and/or experience may be considered.
A minimum of 3-5 years of Managed Care, Medicaid, Medicare experience required.
A minimum of 3-5 experience in design and delivery (facilitating and coordinating) of training programs.
Must have 3 years experience in Healthcare Industry.
Managed Care experience.
Appeals & Grievances experience-preferably as Lead.
3 years experience designing and conducting trainings as a true Trainer.
Strong understanding of learning principles and ability to demonstrate in classroom (or virtual classroom) situations.
Knowledge of CA regulatory guidelines, Medi-Cal guidelines, Medicare guidelines, NCQA requirements.
Skilled in group facilitation and managing effective discussion and dialogue to enhance the learning experience.
Strong organizational & analytical skills.
Ability to conduct effective and engaging presentations in a variety of delivery settings.
Ability to interpret technical data, processes, operating and maintenance instructions and procedure manuals.
Must be a strong team player willing to work toward achieving team goals.
Must be flexible to meet the changing training needs.
Professional demeanor.
Commitment to Team Culture.
Excellent written and verbal communications skills.
Proficient using Word, Excel, Power Point and Access.
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Unlock Your Customer Solution Potential: Insight & Career Growth Guide
Real-time Customer Solution Jobs Trends in Los Angeles, California, United States (Graphical Representation)
Explore profound insights with Expertini's real-time, in-depth analysis, showcased through the graph below. This graph displays the job market trends for Customer Solution in Los Angeles, California, United States using a bar chart to represent the number of jobs available and a trend line to illustrate the trend over time. Specifically, the graph shows 77141 jobs in United States and 508 jobs in Los Angeles, California. This comprehensive analysis highlights market share and opportunities for professionals in Customer Solution roles. These dynamic trends provide a better understanding of the job market landscape in these regions.
Great news! Macpower Digital Assets Edge Private Limited is currently hiring and seeking a Customer Solution Center Appeals and Grievance Training Specialist to join their team. Feel free to download the job details.
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An organization's rules and standards set how people should be treated in the office and how different situations should be handled. The work culture at Macpower Digital Assets Edge Private Limited adheres to the cultural norms as outlined by Expertini.
The fundamental ethical values are:The average salary range for a Customer Solution Center Appeals and Grievance Training Specialist Jobs United States varies, but the pay scale is rated "Standard" in Los Angeles California. Salary levels may vary depending on your industry, experience, and skills. It's essential to research and negotiate effectively. We advise reading the full job specification before proceeding with the application to understand the salary package.
Key qualifications for Customer Solution Center Appeals and Grievance Training Specialist typically include Other General and a list of qualifications and expertise as mentioned in the job specification. Be sure to check the specific job listing for detailed requirements and qualifications.
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Before the Interview:To prepare for your Customer Solution Center Appeals and Grievance Training Specialist interview at Macpower Digital Assets Edge Private Limited, research the company, understand the job requirements, and practice common interview questions.
Highlight your leadership skills, achievements, and strategic thinking abilities. Be prepared to discuss your experience with HR, including your approach to meeting targets as a team player. Additionally, review the Macpower Digital Assets Edge Private Limited's products or services and be prepared to discuss how you can contribute to their success.
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