Payment Integrity Enablement Lead & Training

Jobtailor; Rancho Cucamonga (CA); On-site; USD 120,000 - 180,000; Full time

Job summary

Jobtailor seeks a senior leader to oversee the design, implementation, and continuous improvement of Payment Integrity Enablement programs, training modules, and job aids focused on coding accuracy, claim edits, and medical cost containment.

You will direct training delivery for healthcare providers, billing staff, and internal claims analysts to prevent common billing errors and support improved coding accuracy.

Qualifications

• Experience in healthcare payment integrity, revenue cycle, or FWA prevention.
• Leadership experience mentoring, coaching, or training team members.
• Deep understanding of managed care operations and billing regulations.
• Ability to analyze market trends and develop long-term strategies.

Responsibilities

• Manage and oversee design, implementation, and improvement of Payment Integrity Enablement programs and training materials.
• Ensure programs are executed consistently and aligned with regulatory, contractual, and financial expectations.
• Direct training delivery to providers, billing staff, and internal analysts to improve coding accuracy.
• Establish delivery standards, measure effectiveness, and drive adoption of best practices.
• Monitor federal/state regulations (CMS, DHCS) to guide billing and reimbursement training.
• Develop and track KPIs related to training impact and error reduction.
• Collaborate with cross-functional partners on remediation and continuous improvement.
• Lead change management and operational readiness for new billing standards.

Skills

Coding Accuracy

Regulatory Compliance

KPI Development

Risk Assessment

Project Management

Data Analysis

Change Management

Quality Review

Billing Regulations

FWA Prevention

Communication Skills

Interpersonal Skills

Team Leadership

Education

Bachelor's degree in Healthcare Administration

Master's degree in Healthcare Administration or related field

Certified Professional Coder (CPC) / CHA / CCS / PMP

Tools

Microsoft Office Suite

SQL

BI Tools

Data Mining Platforms

Job description

Jobtailor seeks a senior leader to oversee the design, implementation, and continuous improvement of Payment Integrity Enablement programs, training modules, and job aids focused on coding accuracy, claim edits, and medical cost containment.

You will direct training delivery for healthcare providers, billing staff, and internal claims analysts to prevent common billing errors and support improved coding accuracy.