[Hiring] COB Claims Trainer @Gainwell Technologies LLC

Role Description

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.

• 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.

Qualifications

• 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.

Requirements

• Fully remote opportunity within the United States.
• Standard Monday through Friday schedule, generally 8:00 a.m. to 5:00 p.m. Central Time, with flexibility to support training events as needed.
• Frequent collaboration with claims operations, quality, audit, training, and leadership teams.
• Delivery of virtual training, coaching sessions, assessments, and ongoing employee development activities.
• Use of video conferencing, presentation technology, claims systems, workflow tools, and reporting resources to support learning and performance.
• Opportunity to influence operational excellence by improving employee knowledge, accuracy, consistency, and compliance.
• Work in a dynamic healthcare environment supporting Medicaid and commercial claims operations.
• Compliance with all client, company, privacy, security, and healthcare program requirements.

Benefits

• The pay range for this position is $47,000.00 - $67,200.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.
• Generous, flexible vacation policy.
• 401(k) employer match.
• Comprehensive health benefits.
• Educational assistance.
• A variety of leadership and technical development academies to help build your skills and capabilities.