Provider Field Representative

🔥 12 minutes ago

🏄 California – Remote

🏄 California – Remote

💵 $70.3k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• deliver high-quality customer service by responding to inquiries from clients, providers, and internal stakeholders with professionalism, empathy, accuracy, and timeliness • Conduct thorough claims research, provide billing support, and resolve complex issues to build trust, strengthen relationships, and ensure adherence to policies, procedures, and program standards • Facilitate and deliver engaging training sessions for small and large groups, including workshops, seminars, and program-specific group events—both virtual and in-person • Research claim trends, identify recurring provider issues, and analyze data using Excel (pivot tables, filters, formulas, and reporting tools) to deliver actionable insights that improve workflows, reduce errors, and enhance the overall customer and provider experience • Support schedule development for outreach, training, and service initiatives • Track progress, manage deadlines, and proactively identify risks or delays • Escalate issues as needed and recommend solutions to maintain service-level expectations and program timelines

🎯 Requirements

• Strong customer service mindset with excellent verbal and written communication skills • Proven ability to simplify complex billing, policy, and compliance information • Three or more years of experience in the healthcare industry, including insurance, provider support, IT, or operations • Provider billing experience required; working knowledge of CMS-1500 and UB-04 claim forms preferred • Demonstrated ability to work independently and exercise sound judgment when handling sensitive or escalated customer service issues • Hands-on experience researching, resolving, and educating providers on claims processing, billing, and reimbursement; Medi-Cal or Medicaid experience preferred • Strong analytical, organizational, and time-management skills with the ability to manage multiple priorities • Proficiency in Microsoft Excel for tracking, analysis, and reporting, along with basic project management skills for scheduling, progress tracking, and service delivery • Willingness and ability to travel within one or more geographic regions to support provider outreach, training, and relationship-building activities

🏖️ Benefits

• generous, flexible vacation policy • 401(k) employer match • comprehensive health benefits • educational assistance • leadership and technical development academies