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The Provider Claims Training Specialist also known as Regional Representatives, support the provider community in a variety of areas including but not limited to virtual and onsite visits, claims follow up and research support, as well as virtual and face-to-face training development and delivery. Provides training (workshops, seminars, program specific group events) to the provider community and acts as liaison with our internal departments and the customer to implement programs that are necessary for the Medicaid program.

YEAR

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.SummaryThe Provider Claims Training Specialist also known as Regional Representatives, support the provider community in a variety of areas including but not limited to virtual and onsite visits, claims follow up and research support, as well as virtual and face-to-face training development and delivery. These positions act as liaisons between providers and internal departments. The appropriate individuals for these positions will possess strong communication skills, have experience delivering training in-person and virtually, and be available for limited overnight travel. These positions work with providers, provider associations, and directly with the client in support of the Medi-Cal program.Your role in our mission<ul><li>Under minimal supervision, performs routine to complex tasks that are related to provider claiming, program policies, and training.</li><li>Provides training (workshops, seminars, program specific group events) to the provider community and acts as liaison with our internal departments and the customer to implement programs that are necessary for the Medicaid program.</li><li>Provides one-on-one billing support, claim research and analysis, and targeted outreach to providers; supports provider association inquiries and events</li><li>Applies knowledge of established policies and procedures to resolve provider issues, and to work with the customer to ensure compliance.</li><li>Exercises independent judgment within defined practices and procedures to define appropriate actions; escalates areas of concern to leadership/the client as defined by procedures; evaluates unique circumstances and makes recommendations.</li></ul>What we're looking for<ul><li>Three or more years of medical claims processing or provider billing experience, including working knowledge of CMS-1500 and UB-04 claim forms.</li><li>Hands-on experience researching, resolving, and educating providers on claim submission, denials, and reimbursement processes; Medi-Cal or Medicaid experience preferred.</li><li>Strong analytical, organizational, and time management skills, with proven ability to manage multiple provider requests efficiently.</li><li>Excellent communication, presentation, and training skills for both virtual and in-person settings, with a focus on simplifying complex billing and policy topics.</li><li>Willingness and ability to travel within the assigned region to conduct provider visits, outreach events, and training sessions.</li></ul>What you should expect in this role<ul><li>Work from Home, in the San Diego area</li><li>Travel required throughout the assigned geographic region to support training and other provider and account needs.</li><li>For positions assigned to WFH, reliable high-speed internet connectivity is required.\u202f Employees working-from-home may be required to report to the office, at times, to support work efforts.</li></ul>This posting is intended for pipelining. We will accept applications on an ongoing basis.#LI-REMOTE #LI-MA1 #LI-CM1The pay range for this position is $50,000 - $70,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

Gainwell Technologies LLC

Provider Claims Training Specialist - San Diego, CA - Remote

Analysis Skills

Billing

Broadband

Career Development

Claims Processing

Communication Skills

Community Support

Content Management Systems (CMS)

Healthcare

Leadership

Maintain Compliance

Medi-Cal

Medicaid

Organizational Skills

Policy Development

Problem Solving Skills

Procedure Development

Reimbursement

Seminars

Time Management

Training/Teaching

Willing to Travel

Work From Home

Visual acuity that meets the requirements of the position: The worker is required to have close visual acuity to perform an activity such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; expansive reading and visual inspection of employees, visitors or facility. Prepares and processes forms and documents such as training schedules, service performance reports, action plans, travel requests, expense reports, purchase orders, work orders, and contracts, and follows up with management on training and pending information or requests.

Under the guidance of the Senior Vice President of Hospitality and the direction of the Vice President of Hotel Operations, the Manager Training - Hospitality provides enterprise-wide leadership in hospitality training and development. Responsible for elevating service standards across all hospitality operational areas. Executing the Yaamava Brand Standards and collaborating closely with department leaders and Vice Presidents to deliver a best-in-class guest experience.ESSENTIAL DUTIES AND RESPONSIBILITIES<ol><li>Assesses training needs and creates comprehensive plans that align with enterprise guest experience goals. Designs and delivers programs that reinforce Yaamava Brand Standards, Brand Champion Tasks, Forbes Travel Guide, Michelin, AAA standards and any other industry awards key to the operations success and brand positioning</li><li>Performs continual observations and inspections, formally reports findings, and makes recommendations for leadership assessments and continued training on:</li></ol><ul><li>Compliance with policies, procedures, and controls</li><li>Improvements to operational effectiveness</li><li>Health and safety protocols and standards</li><li>Employee effectiveness and performance</li><li>Standard operating procedures</li><li>Mystery Shop Program</li></ul><ol start="3"><li>Develops methods for evaluation of program effectiveness. Monitors and records of training activities. Maintains a current and accurate understanding of Service Standards and guest service expectations, objectives, strategies, and operational plans regarding service excellence. Maintains a current and accurate understanding of policies and procedures for ensuring and coordinating the proper execution of managing service performance systems, reporting, vendor communication, and action planning.</li><li>Collaborates with Hospitality leadership to implement processes and service programs that exceed guest expectations. Promotes a positive, collaborative environment that encourages feedback, recognition, and continuous improvement.</li><li>Conducts observations and inspections, reports findings, and recommends improvements in compliance, operational effectiveness, and team member performance. Evaluates training effectiveness and maintains accurate records of activities.</li><li>Analyzes customer service surveys, responds to guest comments, and provides actionable feedback to department leaders. Stays current on industry trends and services standards through seminars and training sessions. Prepares and processes training schedules, reports, and related documentation.</li><li>Maintains innovative skills by attending seminars and training sessions about new training ideas or philosophies, changes in service standards, policies, and procedures, and/or changes in the casino/hospitality industry.</li><li>Prepares and processes forms and documents such as training schedules, service performance reports, action plans, travel requests, expense reports, purchase orders, work orders, and contracts, and follows up with management on training and pending information or requests.</li><li>Performs other duties as assigned to support the efficient operation of the department.</li></ol>SUPERVISORY RESPONSIBILITIESCarries out supervisory responsibilities in accordance with the organization's policies and applicable laws. Responsibilities include interviewing, hiring and training employees; planning, assigning reviewing and directing work; evaluating and appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems. Make hiring decisions and designs individual development plans with succession planning in mind for all key roles.EDUCATION, EXPERIENCE AND QUALIFICATIONS<ul><li>Bachelor's degree from an accredited college or university is required.</li><li>Minimum three (3) years of career experience in training and development required.</li><li>Minimum three (3) years of supervisory experience required.</li><li>Minimum three (3) years of relevant experience, luxury Hotel, Spa preferred.</li><li>Forbes Travel Guide and AAA Diamond knowledge preferred.</li><li>Related, relevant, and/or direct experience may be considered in lieu of minimum educational requirements indicated above.</li></ul>KNOWLEDGE, SKILLS AND ABILITIES (KSA)<ul><li>Proficiency in Microsoft suite of products and / or Office 365</li><li>Experience in instructional design, assessing needs, performance measurement, training delivery, and training evaluation preferred History of building, leading, motivating, and coaching teams to achieve objectives.</li><li>Must have the ability to communicate verbally across all levels of the organization.</li><li>Must possess high level presentation skills.</li><li>Must have excellent writing skills and strong computer skills covering Microsoft Office applications as well as all compliance applications.</li><li>Experience with the development, assessment or review of quality assurance policies, procedures, processes, and internal controls required.</li></ul>LICENSES, CERTIFICATIONS AND REGISTRATIONS<ul><li>At the discretion of the San Manuel Tribal Gaming Commission, you may be required to obtain and maintain a gaming license.</li><li>No Driving Responsibilities: Role does not require a driver's license or insurance.</li></ul>PHYSICAL REQUIREMENTS/ WORKING CONDITIONS \u2013 ENVIRONMENTThe physical demands and working environment described here are representative of those that an employee encounters and must be met by an employee to successfully perform the essential functions of this job.<ul><li>Primary work environment is in a climate-controlled office setting.</li><li>Work requires travel to attend meetings, trade shows, and conferences.</li><li>Incumbents may be required to work evening, weekend and holiday shifts.</li><li>Must be able to work in a fast-paced, high-demand environment.</li><li>Strength sufficient to exert up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects and/or move up to 40 pounds occasionally.</li><li>Sedentary work: involves sitting most of the time. Constantly operates a computer and other office productivity machinery, such as a calculator, copy machine, and computer printer.</li><li>Physical activities that apply to the essential functions of the position are balancing, stooping, kneeling, crouching, reaching, pushing, pulling, lifting, grasping, talking, hearing, and repetitive motions.</li><li>Hearing sufficiently to hear conversational levels in person, via videoconference and over the telephone.</li><li>Speech sufficient to make oneself heard and understood in person, in front of groups, in meetings, via videoconference and over the telephone.</li><li>Visual acuity that meets the requirements of the position: The worker is required to have close visual acuity to perform an activity such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; expansive reading and visual inspection of employees, visitors or facility.</li><li>Mobility sufficient to safely move in an office environment, walk, stoop, bend and kneel, and enter, exit and operate a motor vehicle during travel to promotional events, meetings, conferences, trade shows and San Manuel properties.</li><li>Endurance sufficient to sit, walk and stand for extended periods, and maintain efficiency throughout the entire work shift and during extended work hours.</li><li>The employee may be exposed to fumes or airborne particles including secondhand smoke.</li></ul>Reasonable accommodation will be made in compliance with all applicable law.As one of the largest private employers in the Inland Empire, San Manuel deeply cares about the future, growth and well-being of its employees. Join our team today!

SAN Manuel Band Of Mission Indians

Manager, Training- Hospitality

Brand Positioning

Calculators

Coaching

Computer Skills

Conferences

Continuous Improvement

Copying Machines

Customer Support/Service

Data Analysis

Disciplinary Action

Driver's License

Expense Reports

Gaming

Instructional Design

Insurance

Lift/Move 40 Pounds

Market Surveys

Microsoft Office

Microsoft Product Family

Needs Assessment

Office Equipment

Operational Improvement

Operational Strategy

Operational Support

Operations Management

Operations Planning

Performance Analysis

Performance Management

Performance Metrics

Physical Demands

Presentation/Verbal Skills

Printers

Program Evaluation

Purchase Orders

Quality Assurance

Record Keeping

Standard Operating Procedures (SOP)

Succession Planning

Systems Administration/Management

Team Player

Trade Shows

Travel Planning

Writing Skills

Supporting the digital transformation of the construction industry, Biosite provides technology-enabled solutions that have been specifically designed to optimise operational efficiency, improve health and safety and ensure compliance for construction projects. Biosite's purpose is to support the digital transformation of the construction industry, by being an innovator in developing technology and software solutions that give our customers peace of mind that they are in control of their sites.

<h5>Business Development Manager </h5>Supporting the digital transformation of the construction industry, Biosite provides technology-enabled solutions that have been specifically designed to optimise operational efficiency, improve health and safety and ensure compliance for construction projects. Biosite's purpose is to support the digital transformation of the construction industry, by being an innovator in developing technology and software solutions that give our customers peace of mind that they are in control of their sites. Underpinned by a unique biometric algorithm, Biosite provides market-leading software solutions for workforce management, task management, material management and fire safety & security. At the heart of all Biosite solutions is the capture of quality data that is converted to valuable real-time insight, enabling our customers to make more informed decision making. Following our recent acquisition by ASSA ABLOY and our continued success in the UK market, Biosite is expanding into new geographies and as such is recruiting for a Regional Sales Manager for the US. Focusing on the construction market, you will implement new business sales strategies that you have developed specifically to drive sales and growth within your region. As well as managing the strategy, you will also be hands on; liaising with clients directly and negotiating contracts. The successful candidate will have an opportunity to develop the role and make their mark in what is a rapidly growing technology company leading the way in workforce management for construction. The position is a field-based role. Main Responsibilities and Tasks: <ul><li>Develop and implement sales strategies for the whole region. </li><li>Forecasting and reporting on sales activity within the region. </li><li>Working closely with the Managing and Commercial Directors to ensure product and commercial offering is suitable for continued growth and sales. </li><li>Generating new business through various means of lead generation such as telephone prospecting, physical prospecting, existing client relationship development, etc. </li><li>Taking full ownership for sales within the region and portfolio of key accounts; developing profitable sales through promoting additional services and value-added solutions. </li><li>Managing the sales process from initial prospecting stage through the securing the order and ensuring successful implementation, with a focus on customer satisfaction and retention. </li><li>Actively managing and developing the growth of product sales within the region. </li><li>Effectively and efficiently analyzing, implementing, and controlling the opportunities within the region. </li><li>Taking ownership for account performance, including: Ensuring ongoing retention and maximizing opportunities Owning performance against financial targets, and Renegotiating renewals. </li><li>Developing executive level relationships. </li><li>Maintaining your own prospecting and lead generation database. </li><li>Managing your own diary and time. </li></ul>Key working relationships (internal and external): <ul><li>Ensure sales targets are met and maximizing opportunities and ensuring positive impact of the Biosite reputation and proposition. </li><li>Working closely with the Sales and Marketing team on the development of sales assets, with the opportunity to make recommendations direct to the Commercial Director and Managing Director. </li><li>Working closely with new customers to build successful trading relationships. </li><li>Developing your own customer network. </li></ul>Person profile: Essential qualifications, experience, knowledge and behaviors: <ul><li>A thorough understanding of the sales / key account process with a minimum of five years' successful/appropriate construction or key account experience. </li><li>Proven track record of business development at all levels, with added value relating to construction, construction software or security solutions. </li><li>Strong sales and presentation skills - including probing, listening, and closing, especially in-depth investigation. </li><li>Solid understanding of the business and its strategy, with the ability to integrate this into daily activity, with the ability to take this forward into identifying opportunities to maximize product sales across multiple sectors and applications. </li><li>Experience of developing and owning account plans, with a track record of delivering against account plans, new or existing accounts, bids or tenders. </li><li>Commercially aware with total business orientation and able to understand labor rate to material costs argumentation, plus able to understand and present a "value proposition" to clients or potential clients. Articulation of this is key to success. </li><li>An open communication style; friendly, conscientious, and committed team player. </li><li>A highly personable relationship builder and able to engage at all levels including Directors, Project Managers, Quantity Surveyors, Buyers, Procurement etc. </li><li>Excellent presentation skills are also important together with strong negotiation, commercial and analytical skills. </li><li>Naturally persuasive, creative, and self-motivated; able to recognize opportunities and use your own initiative to convert these into sales. </li><li>A high degree of numeracy, computer literacy and a strong ability with Excel, PowerPoint and ability to become highly competent with our own SaaS product is essential to success. </li><li>Due to the nature of the role, experience of selling at both site and senior level is essential. Adaptation to different environments is key. </li></ul>We are the ASSA ABLOY Group Our people have made us the global leader in access solutions. In return, we open doors for them wherever they go. With nearly 63,000 colleagues in more than 70 different countries, we help billions of people experience a more open world. Our innovations make all sorts of spaces – physical and virtual – safer, more secure, and easier to access. As an employer, we value results – not titles, or backgrounds. We empower our people to build their career around their aspirations and our ambitions – supporting them with regular feedback, training, and development opportunities. Our colleagues think broadly about where they can make the most impact, and we encourage them to grow their role locally, regionally, or even internationally. As we welcome new people on board, it's important to us to have diverse, inclusive teams, and we value different perspectives and experiences.

Training and Development Jobs in Victorville, CA

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Training and Development Jobs in Victorville, CA

Provider Claims Training Specialist - San Diego, CA - Remote Gainwell Technologies LLC

Manager, Training- Hospitality SAN Manuel Band Of Mission Indians

Business Development Manager ASSA ABLOY Group

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