Provider Field Representative I

Conduent State Healthcare, LLC • Concord, NH

6d • $47,740 - $62,000 • Onsite

About The Position

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.

The Provider Field Representative I supports New Hampshire Medicaid providers by resolving routine inquiries, delivering MMIS portal guidance, and helping ensure provider satisfaction, operational accuracy, and program compliance.

Requirements

• A minimum of three (3) years of experience in healthcare operations, Medicaid programs, provider relations, claims processing, customer service, or technical program support.
• Minimum of one (1) year of training development, facilitation, or provider education experience.
• Strong analytical, problem-solving, critical thinking and customer service skills.
• Excellent verbal and written communication skills.
• Proficiency with Microsoft 365 applications, including Outlook, Word, Excel, PowerPoint, and Teams.
• Ability to manage multiple priorities and work effectively in a fast-paced environment.

Nice To Haves

• Knowledge of New Hampshire Medicaid policies, provider enrollment processes, claims adjudication, and reimbursement methodologies.
• Experience using Medicaid Management Information Systems (MMIS) or similar healthcare systems.
• Understanding of provider billing practices, healthcare regulations, and Medicaid program requirements.
• Experience supporting healthcare providers through training, outreach, or account management activities.
• Have an associate’s degree.

Responsibilities

• Serve as a primary point of contact for New Hampshire Medicaid providers regarding claims, enrollment, billing, and MMIS portal inquiries.
• Build and maintain positive working relationships with providers, state partners, and client stakeholders.
• Conduct provider training on MMIS portal functionality, including claims submission, eligibility verification, enrollment and revalidation activities, and reporting tools.
• Act as a liaison between providers, operations teams, and state partners to facilitate issue resolution and ensure adherence to established processes.
• Research, troubleshoot, and resolve routine provider issues related to claims processing, provider enrollment and revalidation, portal access and navigation, billing inquiries, and policy guidance.
• Escalate complex issues appropriately and follow through to resolution.
• Support provider outreach initiatives, operational improvements, and special projects as assigned.
• Assist in resolving provider concerns, disputes, and service-related issues in a professional and timely manner.
• Apply working knowledge of Medicaid operations, provider relations, and healthcare business practices to support program objectives.
• Analyze information, policies, and procedures to make sound recommendations and decisions within established guidelines.
• Communicate effectively with internal and external stakeholders, ensuring accurate and consistent information is provided.
• Maintain compliance with contractual requirements, state regulations, organizational policies, and operational standards.
• Perform other duties as assigned.

Benefits

• Health and Welfare Benefits
• Retirement Savings
• Employee Discounts
• Career Growth Opportunities
• Paid Training
• Paid time off
• health insurance coverage
• voluntary dental and vision programs
• life and disability insurance
• a retirement savings plan
• paid holidays
• paid time off (PTO) or vacation and/or sick time

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: Associate degree