Claims Trainer

Job Summary

Transforming complex claims rules into actionable training, the full-time Claims Trainer will design and deliver educational sessions for examiners while managing logistics and certification processes, ensuring compliance and quality in claims processing.

Key responsibilities

• Design and deliver training sessions on adjudication logic and system navigation for examiners and support staff
• Manage classroom logistics, including session scheduling and certification tracking, to ensure smooth training operations
• Convert audit findings into targeted refresher training and develop training capabilities in team leads to enhance knowledge sharing

Required qualifications

• Bachelor's degree or equivalent experience in health insurance claims
• 5+ years of experience in processing, auditing, or configuring health insurance claims
• 3+ years of experience in building or delivering training curriculum in a health plan or managed care organization
• Experience with Medicare Advantage, Medicaid, or ASO/self-funded claims
• Working knowledge of core claims platforms and standard claims coding