• Claims Trainer/Quality Coordinator

    Job Locations US-IL-Aurora
    Posted Date 7 days ago(1/9/2019 12:53 PM)
    # of Openings
    Medical Claims
  • Overview




    Looking for a way to influence the health and healthcare of many?


    If so, we’d love to hear from you! Our mission-driven organization is focused on theTriple Aim - Better Health, Better Healthcare and Lower Costs to individuals and their families who participate in our health plans.


    UNITE HERE HEALTH serves 100,000+ workers and 220,000 covered lives in the hospitality and gaming industry nationwide. Our desire to be innovative and progressive drives us to develop impactful programs and benefits designed to engage our participants in managing their own health and healthcare. Our vision is exciting and challenging. Please read on to learn more about this great opportunity!



    Key Attributes:


    • Integrity – Must be trustworthy and principled when faced with complex situations
    • Ability to build positive work relationships – Mutual trust and respect will be essential to the collaborative relationships required
    • Communication – Ability to generate concise, compelling, objective and data-driven reports
    • Teamwork – Working well with others is required in the Fund’s collaborative environment
    • Diversity – Must be capable of working in a culturally diverse environment
    • Continuous Learning – Must be open to learning and skill development.  As the Fund’s needs evolve, must be proactive about developing new areas of expertise
    • Lives our values – Must be a role model for the Fund’s BETTER Culture and Mission (Better, Engage, Teamwork, Trust, Empower, Respect)




    The purpose of this position is to evaluate the Claims department workforce with the intent of enhancing professional learning and development. This position will assist management in ongoing and long-term employee auditing, training and development through classroom learning, one-on-one training and coaching as well as objective auditing delivered through standardized forms and verbal feedback.


    • Conducts job analyses and processes reviews
    • Creates training materials and job aids for training and coaching
    • Conducts role-specific training classes
    • Coordinates with management to identify training and development opportunities
    • Identifies and analyzes trends and provides insight to management regarding department efficiency
    • Improves and ensures quality of claim handling practices
    • Monitors and delivers feedback to management on the progress of training classes and coaching efforts
    • Maintains quality and productivity standards through training and coaching
    • Calculates weekly and monthly audit results
    • Partners with other areas of the organization to coordinate training efforts and makes recommendations for improvement of interdepartmental business processes
    • Provides support for claim resolution by gathering and communicating information to develop procedures for complex claim handling
    • Set goals and achieve measurable results
    • Contributes ideas to plans and achieving department goals
    • Performs other duties as assigned within the scope of responsibilities and requirements of the job
    • Performs Essential Job Functions and Duties with or without reasonable accommodation


    • High School Diploma or GED
    •  2 ~4 years of related experience minimum
    • Working knowledge and experience in interpretation of health benefit plans, an understanding of limitations, exclusions, and schedule of benefits
    • Experience handling the evaluation of workforce training and development needs and execution of subsequent training efforts

    Skills and Abilities:

    • Advanced level Microsoft Office skills (PowerPoint, Word, Outlook)
    • Advanced level Microsoft Excel skills
    • Problem solving, multi-tasking, analytical, and decision making skills
    • Attention to detail, time management, organizational, and investigative skills
    • Communication skills (written and verbal)
    • Ability to lead a classroom discussion, engage participants and create a cooperative training environment
    • Ability to deliver coaching and performance feedback in a strategic fashion
    • Ability to work collaboratively with all levels of staff


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