Claims Education Specialist

GENERAL PURPOSE

As part of the claims services team, you will be responsible for identifying training needs, developing education, delivering training, and assessing its effectiveness. You will serve as a liaison to other departments internally and stakeholders externally. You will take the lead in training and developing our claims leads and contribute to our CR1 team as a trainer and resource. 

 

ESSENTIAL DUTIES / RESPONSIBILITIES

Curriculum Design and Development:

• Design, develop, and maintain engaging and effective training programs for Pinnacol's claims team, including new hire onboarding, continuing education, and specialized training in fraud investigation, medical case management, and legal issues.
• Develop various training materials, such as interactive online modules, presentations, instructor guides, job aids, and assessments, utilizing adult learning principles to maximize knowledge retention and application.

Training Delivery and Facilitation:

• Deliver training programs through various formats, including in-person workshops, webinars, and online learning platforms.
• Facilitate engaging learning experiences that encourage participation, collaboration, and knowledge sharing.

Needs Analysis and Evaluation:

• Conduct needs assessments to identify knowledge gaps and training priorities within the claims department.
• Manage our internal audits and conduct claim audits to help inform any trends and needs within the discipline. 
• Evaluate the effectiveness of training programs through surveys, assessments, and performance data analysis, making adjustments as needed to improve training outcomes continuously.

Standard Work Development and Maintenance:

• Collaborate with claims team members to document and maintain current standard work procedures.
• Analyze workflows and processes to identify opportunities for improvement and efficiency.
• Develop and deliver training on updated standard work procedures.

Collaboration and Partnership:

• Partner with the Learning and Organizational Development team to align claims training with broader organizational learning initiatives.
• Collaborate with claims leadership, subject matter experts, and external stakeholders (e.g., the Division of Workers' Compensation) to ensure training content is accurate, up-to-date, and relevant.

Mentorship and Development of Claims Staff:

• Serve as a claims subject matter expert resource for claims staff when assistance/staffing/authority is required.
• Mentor and develop claims professionals towards an advanced career path.

Planning and Organization of High-Volume Tasks and Projects:

• Schedule, prepare, and develop quarterly all claims meetings and coordinate additional resources as needed. 
• Manage and prioritize business support tickets to ensure the claims teams have the necessary tools. 
• Serve as project leader and a member on various projects as needed.

 

ADDITIONAL DUTIES

• Other projects and tasks as needed by discipline.
• May require management of claims in the event of a material increase in volume or a vacancy

 

MINIMUM QUALIFICATIONS

Extensive knowledge of Colorado workers' compensation is required. Experience at a Sr. Claims Rep level or above needed, including 5 years of Pinnacol claims discipline knowledge preferred. Must demonstrate self-motivation and independent thinking.

Competencies:

• Problem-solving skills - Able to independently analyze problems and develop solutions. 
• Organization - Able to maintain multiple priorities, projects, and tasks while maintaining performance and the ability to respond to CR's needs immediately. 
• Time management - Ability to work effectively and efficiently when competing priorities exist. 
• Communication- Strong written and verbal communication skills. Must confidently communicate new standards or directives to employees or stakeholders at varying levels and sizes. 
• Relationship Building - Able to foster trust internally and externally. Must identify and adjust to different learning types to maintain confidence and relationships.
• Adaptable and Innovative - Must be able to adapt to constantly changing landscapes and have the ability to innovate solutions based on change. 

 

WORK ENVIRONMENT / PHYSICAL ACTIVITIES

Regular attendance requires extensive customer interaction and computer work in an office or home environment.

We can’t do our work without people like you.
Our employees are extraordinary and committed to making a difference. Here are some of the ways we show our appreciation.

• Our benefits go beyond the basics. You can choose from diverse medical, dental, and vision benefit offerings.
• We care about each other. We enjoy a positive, collaborative work environment. We are hard workers and high performers.
• We love who you are. Pinnacol is on a journey to embody diversity, equity and inclusion. We’re committed to creating a culture that deeply values differences, where everyone feels like they belong.
• Take a day (or 20!) off. In your first full year, you'll enjoy 20 paid days off plus nine paid holidays.
• Take care of yourself. Sign up for unique wellness programs, including on-site, company-paid fitness facilities and classes.
• Get your learning on. We promote a learning culture to help you master your current job and cultivate the skills of the future through various on-site, online, and off-site professional development opportunities.
• Give back and get paid. Through our employee volunteer program, Pinnacol in Action, employees receive paid time off to volunteer with Colorado nonprofits.
• Share in our success. You’ll have the opportunity to earn a quarterly incentive.

When we find the right person, we put our best foot forward with an offer that excites you. We consider what you’d like to be paid, the skills and experience you bring, and what similar jobs pay in the Denver area, and we make sure there’s equal pay for equal work among those you’ll be working with. The compensation for this role is targeted at $111,700 -$122,500. Multiple factors, including your experience and expertise, determine final offer amounts and may vary from the amounts listed above.

Want to love your work? Apply today!

Pinnacol is committed to working with and providing reasonable accommodations to applicants with disabilities. To request assistance with the application process, please email [email protected].

DISCLAIMER:

This description is not an exhaustive list of all duties, responsibilities, or qualifications associated with this job.