Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.
SummaryThe
Provider Field Representatives, also known as Regional Representatives serve as a critical link between providers, customers, and internal teams, ensuring effective communication, timely issue resolution, and proactive engagement. This position supports the provider community in a variety of areas including outreach, research, communications, virtual/onsite visits, as well as virtual and face-to-face training delivery.
The role combines customer inquiry management and basic process/project coordination with provider outreach and training. The role purpose is to manage inquiries, research, outreach and training from onset to completion, to enhance service quality, and Medi-Cal program compliance. This role works with providers (provider trading partners), provider associations, and directly with the client in support of the Medi-Cal program.
Your role in our mission - Under minimal supervision, using independent judgement, respond to inquiries from clients, providers, and internal stakeholders with professionalism and accuracy. Handle claims research, billing support, and issue resolution to build trust and maintain strong relationships. Apply knowledge of policies and procedures to resolve issues and ensure adherence to program standards.
- Plan and deliver training sessions (including workshops, seminars, program specific group events)-both virtual and in-person-covering billing processes, policy updates, and program requirements. Act as a liaison between providers and internal departments to develop training material and implement initiatives that support program goals.
- Provide one on one billing support, claim research and analysis. Coordinate the flow of correspondence, ensuring clarity, accuracy, and timely responses. Maintain organized communication channels to support collaboration across teams.
- Research claim trends, analyze data, and provide actionable insights to improve processes and provider experience.
- Support schedule development, track/own progress of training and outreach deadlines. Escalate risks or delays to keep initiatives on track.
What we're looking for - Excellent verbal and written communication, presentation, and training skills for diverse audiences (virtual and in person settings), with a focus on simplifying complex billing and policy topics
- Three or more years' experience in the healthcare industry in insurance, provider support, IT and operations. Provider billing experience and working knowledge of CMS-1500 and UB-04 claim forms preferred
- Ability to work independently and exercise judgement. Hands-on experience with researching, resolving, educating providers on claims processing, billing, and reimbursement; Medi-Cal or Medicaid experience preferred.
- Strong analytical and organizational skills with the ability to manage multiple priorities; including basic project management capabilities for scheduling and progress tracking of training and outreach tasks.
- Willingness to travel within one or more geographic regions to support outreach and training needs.
What you should expect in this role - Must be a resident of the state of California
- Travel required throughout one or more geographic regions to support outreach, training and other provider and account needs.
- For positions assigned to WFH, reliable high-speed internet connectivity is required.
- The Central CA cities we're targeting include Tulare, Hanford, Lemoore, the Fresno/Madera area, and Visalia. This includes any city located within the following Central California counties: Kings, Tulare, Fresno, and Madera.
#LI-REMOTE #LI-MA1 #LI-CM1
The pay range for this position is $70,000 - $75,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.
Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines "wages" and "wage rates" to include "all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.
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