Training Specialist, Medical Review Audit – Clinical RN

Training Program Design & Development:

• Create and maintain curricula for IPF and IRF claim review, documentation, and payer policy.
• Develop job aids, reference materials, and assessment tools for onboarding and ongoing competency.
• Build training content within LMS and ensure materials reflect current CMS rules.

Training Delivery & Outcomes:

• Deliver training in virtual formats and track performance metrics to evaluate effectiveness.
• Identify gaps via QA results and implement targeted remediation plans.
• Conduct UAT on new audit workflows and update materials before go-live.

Clinical Subject Matter Expertise:

• Serve as authority on IPF medical necessity criteria, DSM-5 diagnoses, and IPF PPS payment.
• Serve as authority on IRF compliance rule, therapy documentation, and IRF PPS payment.
• Monitor regulatory changes and proactively update training content.