Cohere Health
Payment Training Manager
Edtech.com's Summary
Cohere Health is hiring a Payment Training Manager to develop and deliver targeted training programs that improve the accuracy and consistency of medical audit teams. The role involves translating Quality Control feedback into effective educational modules and conducting virtual sessions to enhance auditor knowledge and performance using advanced auditing tools and methodologies.
Highlights
- Develop structured training modules based on complex clinical and coding audit concepts.
- Collaborate with Quality Control Analysts and Concept Developers to address knowledge gaps and integrate new audit ideas.
- Conduct live virtual training and workshops; provide feedback to improve audit quality and productivity.
- Utilize audit technologies such as Cohere Validate, Encoder, Grouper, and Pricer tools effectively.
- Maintain up-to-date expertise in coding guidelines, payment policies, and industry trends.
- Require 8+ years of experience in medical coding, claims auditing, and payment integrity with CCS credential.
- Expertise in CPT, HCPCS, ICD-10-CM coding, and knowledge of outpatient claims for multiple lines of business.
- Proficient in instructional design tools like PowerPoint and Google Slides; excellent communication skills.
- Salary range: $105,000 to $118,000 annually, with benefits including health insurance, 401(k) match, paid parental leave, and pet insurance.
- Engage with a diverse, remote team in a high-growth company recognized for innovation and healthcare impact.
Payment Training Manager Full Description
Payment Training Manager
United States
Opportunity Overview:
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.
Ideal candidates should possess a CCS credential, expert knowledge of CPT, HCPCS, and ICD-10-CM/PCS coding guidelines, and a passion for detailed analytical auditing, play a key role in delivering accurate reimbursement solutions and maintaining audit excellence. The ideal candidate is self-motivated, thrives in a remote and fast-paced environment, and is committed to precision, compliance, productivity, and continuous learning within a high-growth organization.
What You'll Do:
- 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.
What You'll Need:
- 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:
š» Fully remote opportunity with about 5% travel
š©ŗ Medical, dental, vision, life, disability insurance, and Employee Assistance Program
š 401K retirement plan with company match; flexible spending and health savings account
šļø Flex Time Off + company holidays
š¶ Up to 14 weeks of paid parental leave
š¶ Pet insurance
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. In accordance with state applicable laws, Cohere is required to provide a reasonable estimate of the compensation range for this role. Individual pay decisions are ultimately based on a number of factors, including but not limited to qualifications for the role, experience level, skillset, and internal alignment.
Interview Process*:
- Connect with Talent Acquisition for a Preliminary Phone Screening
- Meet your Hiring Manager!
- Behavioral Interview
*Subject to change
About Cohere Health:
Cohere Healthās clinical intelligence platform and agentic AI-powered solutions connect health plansā strategic goals and providersā needs, optimizing the speed, cost, and quality of care. With an enterprise approach that streamlines payer-provider decision-making across the care continuumāincluding policy, prior authorization, payment accuracy, and moreāthe company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.
With the acquisition of ZignaAI, weāve further enhanced our platform by launching our Payment Integrity Suite, anchored by Cohere Validateā¢, an AI-driven clinical and coding validation solution that operates in near real-time. By unifying pre-service authorization data with post-service claims validation, weāre creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately.
Cohere Healthās innovations continue to receive industry wide recognition. Weāve been named to the 2025 Inc. 5000 list and in the GartnerĀ® Hype Cycleā¢ for U.S. Healthcare Payers (2022-2025), and ranked as a Top 5 LinkedInā¢ Startup for 2023 & 2024. Backed by leading investors such as Deerfield Management, Define Ventures, Flare Capital Partners, Longitude Capital, and Polaris Partners.
The Coherenauts, as we call ourselves, who succeed here are empathetic teammates who are candid, kind, caring, and embody our core values and principles. We believe that diverse, inclusive teams make the most impactful work. Cohere is deeply invested in ensuring that we have a supportive, growth-oriented environment that works for everyone.
We canāt wait to learn more about you and meet you at Cohere Health!
Equal Opportunity Statement:
Cohere Health is an Equal Opportunity Employer. We are committed to fostering an environment of mutual respect where equal employment opportunities are available to all. To us, itās personal.
#LI-Remote
#BI-Remote
Similar Jobs
Regional Technical Training and Development Manager
Elevated Facility Services
🇺🇸 Hybrid - Longwood, FL
Sales Training Specialist
Havenpark Communities
🇺🇸 Remote - Romeo, MI
ERP Operations Training Manager
SOLV Energy
🇺🇸 Remote - Bend, OR
Safety Training Specialist - LMS Development & Instructor Led Training Facilitator
Mullins Mechanical
🇺🇸 Hybrid - Atlanta, GA
Training Specialist
Southern Careers Institute
🇺🇸 Hybrid - Austin, TX
