Claims Training Lead: Elevate Exam Accuracy & Compliance

Personify Health; Northern (KY); On-site; USD 65,000 - 78,000; Full time

Benefits offered by this job

Competitive base salary

Comprehensive medical and dental

Unlimited PTO

Mental health support

Retirement planning

Professional development

Mission-driven culture

Job summary

Personify Health is seeking a seasoned Training & Claims Training Specialist to design and deliver examiner training, certify classroom logistics, and convert audit findings into actionable coaching. You will build trainer capability and measure training impact against production metrics.

Responsibilities include standing up training for new initiatives, translating policy updates into guidance, and maintaining a current procedure library with CMS/ERISA compliance considerations.

Qualifications

• Bachelor's degree or equivalent in health insurance claims.
• 5+ years processing, auditing, or configuring health insurance claims across medical, dental, and vision.
• 3+ years building or delivering training curriculum or technical/procedural documentation, ideally at a health plan or managed care organization.
• Experience with Medicare Advantage, Medicaid, or ASO/self-funded claims.
• Claims examiner certification background a plus.

Responsibilities

• Design and deliver examiner training: instructor-led, virtual, and self-paced sessions covering adjudication logic, benefit interpretation, and system navigation for examiners, analysts, and support staff.
• Own classroom logistics and certification: manage session scheduling, progress tracking, and certification.
• Convert audit findings into fast coaching: partner with Quality Audit to identify error trends and turn them into targeted refresher training.
• Build training capability in team leads: train the trainers to enable self-sufficient delivery.
• Measure training against production results: track quality and productivity and adjust curriculum accordingly.
• Stand up training for new initiatives fast: build and launch training for new lines of business and system migrations.

Skills

Training design

Documentation

Quality improvement

Instructional design

Education

Bachelor's degree or equivalent in health insurance claims

Tools

Javelina

ElDorado

QicLink

Facets

Cornerstone

Workday Learning

Visio

Lucidchart

SharePoint

Confluence

Job description

Personify Health is seeking a seasoned Training & Claims Training Specialist to design and deliver examiner training, certify classroom logistics, and convert audit findings into actionable coaching. You will build trainer capability and measure training impact against production metrics.

Responsibilities include standing up training for new initiatives, translating policy updates into guidance, and maintaining a current procedure library with CMS/ERISA compliance considerations.