COB Claims Trainer - Remote (Any city, TX, US, 99999)
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.
Summary
The COB Claims Trainer, Professional is responsible for developing, maintaining, and delivering technical training for Coordination of Benefits (COB), Medicaid Reclamation, commercial medical claims processing, appeals, auditing procedures, reimbursement methodologies, and related operational requirements. This position supports claims operations by ensuring employees understand complex requirements, apply procedures consistently, and complete accurate, compliant work.
This role requires strong technical claims knowledge, effective training and facilitation skills, sound judgment, and the ability to translate complex claims policies, operational procedures, quality findings, and research outcomes into practical training solutions for new and existing employees.
Your role in our mission
- Develop, maintain, and deliver training programs covering Coordination of Benefits (COB), Medicaid Reclamation, commercial medical claims processing, appeals, auditing procedures, and reimbursement methodologies.
- Facilitate virtual instructor-led training, onboarding programs, refresher courses, workshops, and one-on-one coaching sessions for new and existing employees.
- Create and maintain training materials, job aids, process documentation, presentations, assessments, knowledge checks, and standard operating procedures.
- Translate complex claims policies, procedures, and regulatory requirements into clear, practical learning solutions.
- Evaluate learner performance through assessments, observations, and practical exercises, providing coaching and feedback to support success.
- Partner with operations leaders, quality teams, auditors, and subject matter experts to identify training needs and ensure content reflects current business processes.
- Analyze quality reviews, audit findings, and operational trends to identify knowledge gaps and develop targeted training solutions.
- Research policy updates, reimbursement changes, system enhancements, and operational requirements to ensure training content remains current and accurate.
- Update training programs based on changes to Medicaid regulations, client requirements, reimbursement guidelines, and internal processes.
- Serve as a technical resource for employees and leaders regarding COB and Medicaid claims processing procedures.
- Support continuous improvement initiatives by measuring training effectiveness and recommending enhancements to curriculum, delivery methods, and learning resources.
- Perform other auxiliary functions as necessary to support departmental and operational needs.
What we're looking for
- Significant professional experience as a medical claims examiner, claims auditor, claims processor, or subject matter expert within a healthcare claims environment.
- Strong knowledge of Medicaid claims processing, Coordination of Benefits (COB), reimbursement methodologies, claims recovery, Medicaid reclamation, and related operational procedures.
- 3+ years of documented experience in Medicaid reclamation processes, including overpayment identification, recovery efforts, reimbursement reconciliation, and compliance with Medicaid regulations.
- Previous supervisory, team lead, coaching, training, or employee development experience, with the ability to develop technical training materials, process documentation, job aids, and standard operating procedures.
- Excellent presentation, facilitation, communication, and interpersonal skills with the ability to effectively train, mentor, and coach employees in a virtual environment.
What you should expect in this role
- Fully remote opportunity w