Clinical Trainer

Sagility Limited; Bengaluru; On-site; INR 600,000 - 900,000; Full time

Job summary

Sagility Limited is seeking a Clinical Trainer in Bengaluru, India to deliver structured training programs for offshore clinicians. You'll develop and enhance training materials aligned with clinical guidelines and coding standards, and facilitate new hire training for clinical review workflows.

The ideal candidate will hold an active coding certification and have robust experience in clinical review and training roles. This position involves collaborating closely with Quality Assurance and Operations to maintain standards.

Qualifications

• Active coding certification required (CPC, CCS, or equivalent).
• Over 2 years of experience in clinical review and medical coding.
• Minimum 1 year experience in training or coaching roles.

Responsibilities

• Facilitate new hire training programs for clinical review workflows.
• Develop and update training materials based on clinical guidelines.
• Participate in Clinical Rounds sessions to enhance clinicians' skills.
• Design and administer training assessments to track performance.
• Support nesting phases by monitoring trainee performance.

Skills

Clinical judgment

Medical coding accuracy

Adult learning facilitation

Attention to detail

Analytical thinking

Education

RN or allied health professional

Tools

Microsoft Office

Job description

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics.

The Clinical Trainer is responsible for delivering structured training programs for offshore clinicians supporting clinical review (e.g., utilization management, case review, abstraction) and medical coding workflows. This role ensures learners develop strong clinical judgment, accurate documentation practices, and coding proficiency required to support high-quality clinical and coding outcomes. The trainer will lead new hire training, uptraining programs, and ongoing skill development, ensuring alignment with clinical criteria, coding guidelines, quality standards, and productivity expectations. This role collaborates closely with Operations, Quality Assurance, and Client Stakeholders to maintain clinical accuracy, coding compliance, and overall readiness of clinicians handling end-to-end case evaluation.

Key Responsibilities

Training Delivery

• Facilitate new hire training programs covering:
  • Clinical review workflows (UM, case review, abstraction)
  • Medical necessity evaluation and criteria interpretation
  • Clinical documentation standards
  • ICD-10, CPT, and HCPCS coding systems
  • System navigation and operational procedures
• Deliver uptraining modules, including but not limited to:
  • Complex and high-risk case reviews
  • Appeals and edge-case clinical scenarios
  • Documentation-driven coding accuracy
  • Specialty-specific scenarios (e.g., inpatient, outpatient, oncology)
• Conduct case-based discussions to reinforce clinical judgment, documentation accuracy, and coding application.

Curriculum Development

• Develop and update training materials based on:
  • Clinical guidelines and medical necessity criteria
  • Coding standards and regulatory updates
  • Standard Operating Procedures
• Translate clinical and coding requirements into practical learning tools, including:
  • Case simulations
  • Clinical review and coding exercises
  • Job aids and quick reference guides
• Ensure training materials remain aligned with client requirements and compliance standards.

Clinical Rounds & Knowledge Integration

• Participate in and facilitate Clinical Rounds sessions to reinforce clinical reasoning and case interpretation.
• Bridge gaps between clinical review, documentation, and coding outcomes.
• Standardize understanding of complex and specialty cases.
• Convert Clinical Rounds insights into training enhancements, case libraries, simulation scenarios, FAQs, and job aids.

Competency Assessment

• Design and administer training assessments including:
  • Knowledge checks
  • Clinical scenario evaluations
  • Coding and documentation exercises
• Track trainee performance and maintain training scorecards and readiness reports.
• Ensure trainees meet required quality and accuracy thresholds prior to certification.

Quality, IRR & Performance Alignment

• Partner with QA teams to identify clinical and coding error trends and incorporate audit feedback into training modules.
• Conduct targeted refresher sessions.
• Participate in Inter-Rater Reliability (IRR) activities, including calibration sessions to ensure consistency in clinical interpretation and coding application.
• Align with QA, Operations, and client reviewers on case decisions.
• Support IRR improvement initiatives through targeted training interventions.

Post-Training Support

• Support nesting and ramp phases by monitoring trainee performance, providing coaching and remediation, and conducting refresher training where required.
• Assist operations leadership in reducing clinical errors, coding inaccuracies, and rework.

Stakeholder Collaboration

• Work closely with Operations leadership, Client stakeholders, and Quality teams.
• Provide regular updates on training outcomes, learner readiness, IRR alignment, and performance improvement opportunities.

Minimum Qualifications

Education

Clinician (RN or allied health professional preferred).

Certification

Active coding certification required (CPC, CCS, or equivalent).

Experience

• Over 2 years of experience in clinical review (UM, case management, or abstraction) and medical coding.
• Minimum 1 year experience in training, coaching, or SME roles.
• Experience participating in calibration sessions, audits, or IRR activities preferred.

Knowledge

• Clinical review processes and medical necessity criteria.
• ICD-10, CPT, and HCPCS coding systems.
• Clinical documentation and case review standards.
• Coding compliance and audit requirements.
• Understanding of IRR principles and quality calibration processes.

Key Skills

• Clinical & Coding skills: strong clinical judgment and decision-making capability, ability to connect clinical findings with coding outcomes, high attention to detail in documentation and coding accuracy, ability to identify documentation gaps impacting both review and coding.
• Training skills: adult learning facilitation, classroom and virtual training delivery, assessment design and learner evaluation, coaching and mentoring capabilities.

Technical Skills

• Proficiency with Microsoft Office tools.
• Experience with clinical review, coding, or abstraction platforms.
• Ability to navigate multiple systems simultaneously.

Competency

• Clinical judgment and decision support.
• Coding accuracy and compliance.
• Instructional facilitation.
• Attention to detail.
• Analytical thinking.
• Communication and presentation skills.
• Stakeholder collaboration.
• Continuous learning and improvement.

Working Conditions

Onsite work at Sagility delivery center. May support early or late shifts depending on training schedules. Coordination with US-based stakeholders. Location: BLR, Surya Wave Building, India.