Senior Provider Field Representative - Washington, DC

Gainwell Technologies LLC

1d•$69,100 - $98,700•Hybrid

About The Position

The Senior Provider Field Representative, supports the provider community in a variety of areas including but not limited to virtual and onsite visits, claims follow up and research support, as well as virtual and face-to-face training development and delivery. These positions act as liaisons between providers and internal departments. The appropriate individuals for these positions will possess complex claims resolutions, strong communication skills, have experience delivering training in-person and virtually, and be available for local travel in the DC metropolitan area. This senior role also encompasses account management, relationship building with key partners in the DC area at senior leadership levels. These positions work with providers, provider associations, and directly with the client in support of the District’s Medicaid programs.

Requirements

Demonstrated account management and provider relations skills, delivering responsive, personalized support to assigned providers or provider communities.
Experience in provider-facing roles within Medicaid or Medicare environments (preferred), including provider relations, training, contracting, billing, or complex claims processing.
Strong understanding of provider operations and managed care, including medical claims resolution and key healthcare business transactions.
Advanced analytical, communication, and presentation skills, including Excel-based reporting and analysis, training facilitation, and executive-level (C-suite) communication.
Ability to develop and apply consulting-based solutions with independent judgment, and willingness to travel within the DC Metro area as needed.

Responsibilities

Develop and manage strong relationships with assigned providers or provider communities, serving as the primary point of contact and trusted “go-to” resource.
Proactively address provider needs and potential issues to ensure satisfaction, confidence, and effective collaboration.
Perform routine to complex tasks related to provider claims, program policies, and training with minimal supervision.
Provide training and support to the provider community through workshops, seminars, group events, and one-on-one billing assistance; act as a liaison between providers, internal teams, and the client.
Resolve provider concerns by applying established policies and independent judgment, escalating issues as needed, and driving timely resolution and compliance.