Senior Claims Trainer and Technical Specialist
 HealthPartners | |
 | |
 Mar 04, 2026 | |
|
HealthPartners is hiring a Senior Claims Trainer and Technical Specialist to join our Riverview Claims Department. The Senior Claims Trainer and Technical Specialist helps operations by assisting leaders and peers in examining workflows, identifying opportunities for improvement, and delivering insights that guide leaders' decisions. This role ensures that claims processes are efficient, accurate, and aligned with organizational goals. The position provides strategic direction on process enhancements, evaluates operational data trends, and partners with leadership to implement improvements that support quality outcomes, regulatory compliance, and continuous refinement of departmental performance. This role serves as a key resource for understanding system behavior, operational bottlenecks, and the downstream impact of process changes. This position leads crossdepartment efforts to streamline work, improve automated functions, and support a consistent experience for members, providers, and internal teams. Training and Resources Activities: Provides expertise in training for new and existing employees of system functionality including all modules of the claims system and DEC applications. Formulate training sessions based on department needs including but not limited to: systems, products, compliance requirements and member and provider experience. Develop staff technical competence to ensure maximum production and quality standards. Design and revise procedures as necessary to facilitate claim processes are as efficient as possible. Train employees across employee hierarchy (front line to leadership) to assist in the development of knowledge, skills and abilities. Coaches and mentors to department trainers. In partnership with leadership, address performance issues with claim staff, providing input on development and training needs for employee specific scenarios. Create and develop departmental and interdepartmental policies & procedures and resources to support Claims and other departments as needed. Analyze other department and corporate information for inclusion in department resources. System Support Activities Develop and recommend potential system enhancements and modifications of Claim applications and other health plan systems. Assist with testing system enhancements and modifications of Claim applications and other health plan systems. Work with the Claim Benefit team to coordinate Claim benefit set up for administered products. Audit benefit set-up within the claim system to ensure accurate adjudication of claim. Assists Claim staff and other Riverview (HealthPartners) departments as the primary technical resource regarding questions/problems related to the use of Claim and Health plan system applications and their processes. Identify potential improvements in automated or manual processes; suggest changes to improve processes, update user documentation and operational procedures including enhancements in auto adjudication rates. Works with Claims Leadership team to implement enhancements and manage change. Designs and revises procedures as necessary to facilitate and make claims processing as efficient as possible. Additional Accountabilities: Actively participate in cross-functional initiatives, projects, and reoccurring inter-departmental meetings. Appling experience and expertise to ensure claims experience meets HealthPartners expectations. Participate in business continuity planning and implementation. Actively participates in the preparations for regulatory audits, including universe and file submissions, documentation requirements and presentations to compliance regulators. Perform other duties and projects as assigned by supervisor, manager, or director. Supports departmental and divisional teams through participation and appropriate meetings and projects. Support includes coordination of all processes affected by a project to capture complete information for appropriate training documentation and implementations. Interacts with other supervisors and personnel from other department or organizations to resolve mutual problems. Participates in departmental planning and redesign. Required Qualifications:
Preferred Qualifications:
| |