Job Purpose
The Trainer is responsible for conducting medical billing, claim denials & appeals, revenue cycle management training programs for new and existing forensic billers. Performs actual medical billing & claim denials work for existing accounts on a regular basis to keep an up-to-date knowledge of the process. Participates in process implementation during account take offs or go-live.

Duties and Responsibilities

Develops curriculum, training syllabus, and course modules related to Medical Billing (US Health Insurance, Claims Process, Denials & Appeals, Revenue Cycle Management)
Develop basic account navigation workflow of billing system for both HP and PB (Epic, Athena) and other system tools (Encoder Pro, CCI Edit) used by the department
Develops denials process workflow for common denials (Duplicate, Timely Filing, No Prior- Auth, Medical Necessity, etc.)
Develops a guideline for common payer policies for US health insurance payers
Update and improve existing training and process modules
Coordinate with forensic quality department to identify areas for process improvement and produce materials for claim edits, denials workflow, systems & process training from client
Develops and produces materials for Medical Billing, Denials, systems and process exercises and qualifying examinations
Updates weekly deck (performance and attendance for training meeting)
Participates in weekly training meetings with the upper management
Collaborates with billing operations managers, supervisors, and quality to resolve issues that impact internal and external customers




Develops and conducts Call/Phone Handling Training for the new hires and existing forensic billers
Other duties as assigned
Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
Understand and comply with Information Security and HIPAA policies and procedures at all times
Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties

Qualifications

Previous training work experience of at least a year
Minimum of 2 years of medical billing or revenue cycle management experience specific to AR and Denials Management or provider side of the healthcare insurance industry
In-depth understanding of claim denials
CPB and Coding Certification (CPC, CCS, COC) is an advantage
Supervisory experience preferred; demonstrated leadership skills
Willingness and flexibility to work extended hours
Knowledge of general computer applications and ability to multitask on two monitors.
Ability to work in a team fostered environment and have the willingness to adjust to changing job responsibilities, shifting schedules, new procedures and unexpected workloads and stresses
Assertive self-starter who can work independently, yet function in a team environment
Good interpersonal and other training soft skills




An understanding and strict adherence to all HIPAA regulations
Proficiency in Microsoft Office Suite
Strong interpersonal skills, ability to communicate well at all levels of the organization
Solid problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
High level of integrity and dependability with a strong sense of urgency and results oriented
Excellent written and verbal communication skills required

Working Conditions

Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.
Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
Work Environment: The noise level in the work environment is usually minimal.

Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

📌 Trainer (Chennai)
🏢 Med-Metrix
📍 Chennai