[Remote] Operations Trainer (Remote)

Note: The job is a remote job and is open to candidates in USA. Evry Health is a next-generation health plan focused on simplifying healthcare for its members. The Remote Virtual Claims & Customer Service Trainer is responsible for designing and delivering training programs for contact-center and claims operations staff, ensuring they are equipped with the necessary skills and knowledge to excel in their roles. This position involves onboarding new hires, ongoing training, and developing training materials to enhance operational efficiency.ResponsibilitiesDeliver engaging, interactive training sessions via Teams platform for new hires and tenured staff covering product knowledge, soft skills, and systems navigationLead structured onboarding programs covering Evry Health’s products, systems, workflows, policies, and member-centric service standardsDesign and facilitate live role-play scenarios that mirror real customer interactions, claims inquiries, and escalation situationsCombine synchronous instructor-led sessions with asynchronous e-learning modules, job aids, and recorded contentAdminister knowledge checks, quizzes, and skills assessments to confirm learner readiness before live deploymentMonitor staff performance; identify training gaps and deploy targeted interventions to address deficiencies quicklyCollaborate with Operations leadership to craft clear, timely change communications that prepare agents for upcoming system or workflow transitionsTrain staff on end-to-end claims lifecycle, adjudication, issue identification and remediation, including testing outcomes, denial, adjustment, and dispute proceduresDeliver training on Texas Insurance Code Chapter 1467, prompt-pay requirements, IDR processes, and CMS guidelinesProvide foundational instruction on ICD-10, CPT, HCPCS, and modifier usage as it relates to claims review and provider disputesTrain staff on internal and external dispute resolution processes, timelines, and documentation requirementsTrain agents on Evry Health’s call-handling protocols and quality expectationsCoach staff on professional, empathetic communicationReinforce 1-business-day (member) and 2-business-day (provider) correspondence turnaround standards and documentation requirementsBuild staff confidence in identifying, documenting, and escalating complex or sensitive cases to supervisory and clinical teamsAlign training content with QA audit rubrics covering call quality, case accuracy, and documentation standardsDevelop and maintain SOPs, job aids, desk-top procedures, e-learning modules, and quick-reference guides for all operational workflowsBuild comprehensive knowledge assessments with scoring rubrics aligned to benefit program content and operational standardsPromptly revise training materials in response to regulatory changes, system updates, or operational policy revisionsUpload, organize, and track training completion recordsGenerate training completion reports, assessment score summaries, and gap-analysis data for Operations leadershipPartner with subject matter experts across Claims and Customer Service Operations to capture process knowledge, workflow nuances, and performance expectations, then translate that expertise into role-specific curriculum with the level of detail required for staff to accurately and confidently perform their job functionsReview and restructure existing Desktop Procedures (DTPs) and current operational documentation, consolidating and reformatting content into a consistent, standardized format aligned with Operations’ style and readability requirementsSkillsBachelor's degree in Business, Healthcare Administration, Education, Communication, or a related field; or equivalent work experience3–5 years of experience in health plan operations (claims and/or customer service); minimum 2-4 years in a training, coaching, or instructional role. Strong preference for background in operations and contact centersWorking knowledge of claims adjudication, appeals/grievances, EOBs, ICD-10/CPT coding. Texas Insurance Code knowledge is a plusDemonstrated expertise in contact-center operations including call quality, and member/provider communication standards (both verbal and written)Proven ability to engage and manage remote audiences via Zoom, Microsoft Teams, or equivalent video-conferencing platformsExperience with Salesforce, Vonage, and/or comparable CRM, telephony, and health plan platformsExceptional written and verbal communication skills; ability to translate complex regulatory and clinical content into plain-language trainingStrong project-management skills with the ability to manage multiple training cohorts, deadlines, and content-revision cycles simultaneouslyCertification in instructional design, adult learning (CPLP, ATD), or a related credentialExperience with e-learning authoring tools such as Articulate 360, Rise, or Adobe CaptivateFamiliarity with CMS Star Ratings, NCQA, or URAC accreditation standardsPrior experience supporting UAT, system rollouts, or technology implementation projectsBackground in employer-sponsored health plan administration/ Commercial health insuranceExperience building and administering knowledge-check assessments with scoring rubricsBenefitsFully remote; home office with reliable high-speed internet required.Evry Health-issued laptop, headset, and collaboration tools provided.Company OverviewEvry Health makes healthcare affordable and high quality again by providing expanded benefits at an affordable price. It is a sub-organization of Globe Life. It was founded in 2017, and is headquartered in Mountain View, California, USA, with a workforce of 51-200 employees. Its website is http://www.evryhealth.com.