Payment Training Manager

About the role

We are seeking a versatile and highly skilled Payment Training Manager to join our dynamic Payment Integrity team. This critical role translates Quality Control (QC) feedback and concept development insights into actionable high-impact training programs for our medical audit team to drive accuracy and reduce variance.

Responsibilities

• Translate complex clinical and coding audit concepts into structured training modules.
• Partner with QC Analyst to isolate systemic auditor knowledge gaps.
• Convert QC error trends into targeted, remedial education updates.
• Work with Concept Developers to build training for new audit ideas.
• Conduct live virtual training sessions and workshops for auditing staff.
• Measure training impact by tracking post-education QC accuracy scores.
• Build interactive training materials for both onboarding and continuous learning.
• Provide clear, constructive, and actionable feedback to auditors to improve quality, productivity, and decision-making accuracy.
• Drive adoption and effective utilization of Cohere Validate, the internal audit support tool, while providing actionable feedback and enhancement recommendations to improve functionality and audit efficiency.
• Demonstrate flexibility in using integrated audit technologies, including Encoder, Grouper, and Pricer tools within the internal auditing platform.
• Stay ahead of industry trends, coding changes, and payment policy updates to maintain expert-level knowledge.
• Adhere to HIPAA and company policies to ensure data privacy, security, and regulatory compliance.

Requirements

• 8+ years of overall experience in medical coding, claims auditing, payment integrity, or healthcare reimbursement.
• Expert knowledge of CPT, HCPCS, ICD-10-CM, modifiers, medical necessity, and reimbursement methodologies.
• Deep understanding of outpatient claims coding and auditing for Commercial, Marketplace, Medicare, and Medicaid lines of business.
• Hands-on experience reviewing programs such as HCD, DME, SNF, HH, E&M, Surgery, ASC, Observation, ER, and Infusion claims.
• Excellent written and verbal English communication skills with ability to deliver clear feedback and training.
• Proficiency instructional design tools i.e., PowerPoint, Google Slides.
• Self-motivated and able to work independently in a remote environment while maintaining high performance.
• Strong time management, organization, and attention to detail.
• Commitment to collaboration, coaching, continuous learning, and process improvement.
• Possess CCS (Certified Coding Specialist) credentials.

Nice-to-Haves

• RHIA or RHIT credential.
• Experience using CMS NCDs/LCDs, payer bulletins, and clinical criteria guidelines.
• Prior training and education experience.
• Experience in a high-growth environment with ability to adapt quickly.
• Familiarity working with diverse, global teams.
• Strong computer skills and experience working in Mac environments.
• Experience with reporting tools, dashboards, and data-driven quality improvement initiatives.

Pay & Perks

• Fully remote opportunity with about 5% travel.
• Medical, dental, vision, life, disability insurance, and Employee Assistance Program.
• 401K retirement plan with company match; flexible spending and health savings account.
• Flex Time Off + company holidays.
• Up to 14 weeks of paid parental leave.
• Pet insurance.

Salary Range

The salary range for this position is $105,000 to $118,000 annually; as part of a total benefits package which includes health insurance, 401k and bonus.