Provider Field Representative Lead - Remote California

Gainwell Technologies LLC•Any city, OH

6d•$70,000 - $80,000•Remote

About The Position

The Provider Field Representative Lead provides functional leadership and support to Provider Field Representatives serving California’s Medi-Cal provider community. This role supports team escalations, provider outreach, claims research, provider billing support, and the development and delivery of virtual and in-person training. The Lead also serves as a liaison between providers, provider associations, internal departments, and the client to help ensure consistent service delivery and compliance with Medi-Cal program requirements.

Requirements

Three or more years of business process outsourcing, consulting, systems implementation, provider relations, provider services, or related healthcare operations experience.
Experience supporting healthcare providers with billing, claims research, billing issues, and reimbursement-related questions.
Experience serving as a functional lead, subject matter expert, mentor, trainer, or escalation point for a team.
Experience developing and/or delivering training to healthcare providers virtually and in person.
Strong provider relations, analytical, problem-solving, communication, presentation, facilitation, and functional leadership skills.
Experience working with business processes, assessing provider or client needs, and identifying opportunities for improvement.
Medi-Cal or Medicaid experience preferred.
Willingness and ability to travel throughout California.
Must reside in California.
Reliable high-speed internet connectivity is required.

Responsibilities

Provide functional leadership and direction to Provider Field Representatives, serving as a resource for team escalations, complex provider inquiries, billing questions, claims issues, and program requirements.
Support provider billing activities, including one-on-one billing assistance, claims research and analysis, reimbursement questions, and resolution of provider billing issues.
Support and help direct provider education and outreach, including workshops, seminars, program-specific events, one-on-one training, and provider association activities.
Serve as a liaison between providers, internal departments, and the client to resolve issues and support Medi-Cal programs and initiatives.
Apply established policies and procedures while exercising independent judgment to resolve complex provider issues, identify areas of concern, and recommend appropriate solutions or escalation.
Contribute to shared knowledge resources, document complex issue resolution, and help ensure consistent and accurate information is provided across the team.
Support the development and mentoring of Provider Field Representatives while identifying opportunities to improve provider service, team processes, and overall operational effectiveness.