Description
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:
Fully remote opportunity with about 5% travel
Medical, dental, vision, life, disability insurance, and Employee Assistance Program
401K retirement plan with company match; flexible spending and health savings account
Flex Time Off + company holidays
Up to 14 weeks of paid parental leave
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 Health’s clinical intelligence platform and agentic AI-powered solutions connect health plans’ strategic goals and providers’ needs, optimizing the speed, cost, and quality of care. With an enterprise approach that streamlines payer-provider decision-making across the care continuum–including policy, prior authorization, payment accuracy, and more–the company improves collaboration and reduces burden, resulting in up to 8x ROI and 94% provider satisfaction.
With the acquisition of ZignaAI, we’ve further enhanced our platform by launching our Payment Integrity Suite, anchored by Cohere Validate™, 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, we’re creating a transparent healthcare ecosystem that reduces waste, improves payer-provider collaboration and patient outcomes, and ensures providers are paid promptly and accurately.
Cohere Health’s innovations continue to receive industry wide recognition. We’ve been named to the 2025 Inc. 5000 list and in the Gartner® Hype Cycle™ for U.S. Healthcare Payers (2022-2025), and ranked as a Top 5 LinkedIn™ 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 can’t 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, it’s personal.
