Provider Field Representative Lead

This is a fully remote position, open to applicants in California.

📋 Description

• Offer functional guidance and leadership to Provider Field Representatives engaged with California’s Medi-Cal provider community.

• Assist with team escalations, intricate provider inquiries, billing concerns, claims challenges, and program specifications.

• Provide individualized billing support, claims investigation and analysis, reimbursement assistance, and resolution of provider billing problems.

• Facilitate and direct provider education and outreach initiatives, encompassing workshops, seminars, program-specific events, one-on-one training, and activities with provider associations.

• Act as an intermediary between providers, internal departments, and the client to address issues and support Medi-Cal programs and initiatives.

• Implement policies and procedures while exercising independent judgment to tackle complex provider challenges and suggest solutions or escalations.

• Contribute to collective knowledge resources and document resolutions of complex issues.

• Assist in the development and mentoring of Provider Field Representatives.

• Recognize opportunities to enhance provider service, team processes, and operational efficiency.

• Travel across California for provider training, outreach, events, and other business requirements.

⛳️ Requirements

• At least three years of experience in business process outsourcing, consulting, systems implementation, provider relations, provider services, or related healthcare operations.

• Proven experience in supporting healthcare providers with billing, claims investigation, billing issues, and reimbursement inquiries.

• Experience serving as a functional lead, subject matter expert, mentor, trainer, or escalation point within a team.

• Experience in developing and/or delivering training to healthcare providers both virtually and in-person.

• Strong skills in provider relations, analysis, problem-solving, communication, presentation, facilitation, and functional leadership.

• Experience in analyzing business processes, evaluating provider or client needs, and identifying areas for enhancement.

• Preference for candidates with Medi-Cal or Medicaid experience.

• Must be willing and able to travel throughout California.

• Must currently reside in California.

• Reliable high-speed internet connectivity is essential.

🏝️ Benefits

• Flexible work arrangements.

• Opportunities for learning and career advancement.

• Generous and flexible vacation policy.

• 401(k) employer matching program.

• Comprehensive health benefits package.

• Educational assistance programs.

• Leadership and technical development academies.

• Reimbursement for travel expenses (referenced in the compensation definition).