Claims Trainer

Molina Healthcare Inc., is among the most experienced managed healthcare companies serving patients who have traditionally faced barriers to quality healthcare—including individuals covered under Medicaid, the Healthy Families Program, the State Children’s Health Insurance Program (SCHIP) and other government-sponsored health insurance programs. Molina has health plans in California, Indiana, Michigan, New Mexico, Utah and Washington as well as 21 primary care clinics located in Northern and Southern California with future plans in Ohio and Texas. The company’s corporate headquarters are in Long Beach, California.

Job Overview:

Perform Claims Audits to ensure quality of work of staff. Provide training on QMAC’s. Assist Training Supervisor and Production Supervisors in determining training needs and identifying quality issues.

1. Audits New Hires and completes Internal Audits of existing Staff (Performs at standard of 30 claims per hour) which include high-dollar and/or complex claims. Provides timely feedback of issues to management. Provide input to management on Claim Examiners annual evaluations. Develops appropriate Policy and Procedures.

2. Trains New Hires. Assists in the development of current staff by providing ongoing training as needed. Develops and revises training materials that is used within the Claims organization and for Claims Finance Audit.

3. Teamwork-Rating is based upon individual contribution to the department and meeting the goals of the department. This area will be measured using the outcome of team and departmental goals.

4. Defect reduction-pro-active in identifying error issues and trends and developing plans to resolve these issues.

5. Provide back up to Production Units.

6. Special Projects as assigned.

7. Perform other duties as assigned.

Job Requirements


High School Graduate or Equivalent. College courses or related areas helpful. 5+ years Claims Adjudication Experience. Former Training/Auditing background preferred. Managed Care experience required.

Molina Healthcare offers competitive benefits and compensation package.

Molina Healthcare is an Equal Opportunity Employer (EOE).