Technical Support Claims Coordinator

HealthPartners is hiring a Technical Support Claims Coordinator. This position provides technical supervision and work direction to staff. Assumes the role of unit supervisor in the absence of unit supervisor in the absence of the supervisor. To organize and oversee the expedient and accurate adjudication of claims. To provide the direction, guidance and support necessary to bring about individual development in line with individual needs and department objectives. Serves as a project leader in the use, development, implementation and enhancement of systems, coordinates the activities of all affected areas.

ACCOUNTABILITIES:

1. System Expert: Supports staff in identifying potential improvements in automated or manual processes. Maintains a current knowledge base and utilizes new training techniques and documentation. Ensures efficiency, eliminates redundancy, and utilizes other administrative resources for claims processing needs.
2. Data Interpretation: Facilitates management assimilation of data by interpreting reports and highlighting trends.
3. Support: Supports unit, departmental and divisional teams through participation and appropriate meetings and projects. Support includes coordination of all processes affected by the project to capture complete information for appropriate training documentation and implementation. Interacts with other supervisors and their personnel from other departments or organizations to resolve mutual problems. Participates in departmental planning and redesign.
4. Other Duties: Performs additional duties, attends meetings and assumes projects as assigned by supervisor, manager or director.

REQUIRED QUALIFICATIONS:

1. Bachelor's degree with at least two years of claims experience in the administration of insurance benefits, or Associate degree with two years of HealthPartners experience. Education requirement may be waived based on a minimum of four years of claims processing experience with demonstrated technical expertise.
2. Advanced analytical and problem solving ability.
3. Working knowledge of HealthPartners mainframe systems or equivalent experience with other claims systems.
4. Effective presentation, planning, oral and written communication skills with the ability to communicate at all levels of the organization and with external customer.
5. Detailed knowledge and understanding of the insurance industry including claims processing and customer service expectations.
6. Able to interpret and explain provider and member/employer contracts.
7. Must be highly flexible, able to handle and manage a high degree of change.
8. Able to work independently and as a team player.
9. Knowledgeable of total quality management concepts.
10. Able to identify individual training needs and provide appropriate instruction.

PREFERRED QUALIFICATIONS:

1. Bachelor's degree in management, business administration, or an Associate degree with at least two years of HealthPartners claims processing experience.
2. Working knowledge of HealthPartners claims processing systems.
3. Thorough knowledge of HealthPartners member and provider contracts.
4. Working knowledge of reporting programs.
5. Previous project management experience.
6. Experience using desktop publishing software e.g., Microsoft Word, Excel, PowerPoint and familiarity with training equipment and materials.

DECISION-MAKING:

1. Authority to design and develop training program coursework, create policies and procedures and make logical decisions independently.
2. Is an independent contributor to cost effective processing for the department.
3. Function independently in the areas of auditing and provide feedback to staff.
4. Assists in hiring, firing, coaching and discipline of staff.
5. Approves time off requests.
6. Assist supervisor in the management of work flow, deadlines, and work projects.