Provider Field Representative - Southern California Remote

Gainwell Technologies LLC•Any city, OH

1d•Remote

About The Position

The 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.

Requirements

Strong customer service mindset with excellent verbal and written communication skills, including the ability to facilitate and present training to small and large audiences across both virtual and in-person settings.
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.
Hands-on experience researching, resolving, and educating providers on claims processing, billing, and reimbursement.
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.
Must be a resident of the state of California, with primary residence in Southern California (Santa Barbara, Orange, San Luis Obispo, Kern, or Los Angeles counties).
For positions assigned to WFH, reliable high-speed internet connectivity is required.

Nice To Haves

working knowledge of CMS-1500 and UB-04 claim forms preferred
Medi-Cal or Medicaid experience preferred

Responsibilities

Under minimal supervision and using independent judgment, 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. Training focuses on billing processes, policy updates, compliance requirements, and customer service best practices.
Serve as a liaison between providers and internal departments to translate operational needs into effective training materials and initiatives that support program goals and provider satisfaction.
Provide personalized, one-on-one customer support for billing questions, claims research, and issue escalation.
Coordinate and manage the flow of correspondence to ensure clear communication, accurate documentation, and timely follow-up, maintaining a positive service experience for providers and partners.
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.