Claims Trainer

This is a fully remote position, open to applicants in Texas.

📋 Description

• Design, implement, and deliver training programs focused on Coordination of Benefits, Medicaid Reclamation, processing of commercial medical claims, appeals, auditing practices, and reimbursement strategies.

• Conduct virtual instructor-led training sessions, onboarding initiatives, refresher courses, workshops, and personalized coaching for both new hires and current staff.

• Develop and update training resources, job aids, procedural documentation, presentations, evaluations, knowledge assessments, and standard operating protocols.

• Convert intricate claims policies, procedures, and regulatory guidelines into actionable learning experiences.

• Assess learner performance through evaluations, observations, and hands-on activities, offering guidance and constructive feedback.

• Collaborate with operations leaders, quality assurance teams, auditors, and subject matter experts to determine training requirements and ensure content remains relevant to current practices.

• Review quality assessments, audit results, and operational trends to pinpoint knowledge deficiencies and craft focused training interventions.

• Investigate updates in policies, reimbursement modifications, system improvements, and operational mandates to ensure training material is up-to-date and precise.

• Revise training programs in accordance with Medicaid rules, client specifications, reimbursement protocols, and internal processes.

• Act as a technical expert on COB and Medicaid claims processing protocols.

• Evaluate training effectiveness and suggest enhancements to curricula, delivery formats, and educational resources.

• Execute additional tasks that support departmental and operational objectives.

⛳️ Requirements

• Extensive professional experience as a medical claims examiner, claims auditor, claims processor, or healthcare claims subject matter expert.

• Profound understanding of Medicaid claims processing, Coordination of Benefits, reimbursement strategies, claims recovery, Medicaid reclamation, and associated operational protocols.

• Over 3 years of demonstrated experience in Medicaid reclamation, including identifying overpayments, recovery initiatives, reimbursement reconciliation, and compliance with Medicaid regulations.

• Previous experience in supervisory roles, team leadership, coaching, training, or employee development.

• Capability to create technical training materials, process documentation, job aids, and standard operating procedures.

• Exceptional presentation, facilitation, communication, and interpersonal abilities.

• Proficient in training, mentoring, and coaching employees in a virtual setting.

• Capacity to adhere to client, company, privacy, security, and healthcare program standards.

🏝️ Benefits

• Work flexibility

• Learning and career development

• Flexible vacation policy

• 401(k) employer match

• Comprehensive health benefits

• Educational assistance

• Leadership and technical development academies

• Virtual work arrangement