Provider Field Representative

Gainwell Technologies

Provider Field Representative supporting provider community in areas like claims and training delivery. Working closely with Medicaid programs in the DC metropolitan area and liaising between providers and internal departments.

Posted 7/29/2026full-timeWashington, DC • District of Columbia, Maryland, Washington • 🇺🇸 United StatesMid-LevelSenior💰 $51,700 - $73,800 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in provider relations, claims processing, and training development, with a strong focus on compliance and operational efficiency within the healthcare sector. Capable of delivering effective training and support while liaising with internal departments and providers.

Highest-signal resume keywords

Provider RelationsClaims ProcessingTraining DevelopmentAnalytical SkillsCommunication Skills

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Claims ResolutionProvider ContractingBusiness Process ImprovementPolicy ComplianceMedical Claims Processing

Soft Skills

Presentation SkillsFacilitation SkillsIndependent Judgment

Industry Keywords

MedicaidMedicareProvider OperationsHealth PlanRegulatory Compliance

About the role

Key responsibilities & impact

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
performs routine to complex tasks that are related to provider claiming, program policies, and training
provides training (workshops, seminars, program specific group events) to the provider community and acts as liaison with internal departments and the customer
provides one-on-one billing support, claim research and analysis, and targeted outreach to providers; supports provider association inquiries and events
acts as an escalation point for internal claims staff
liaises with internal departments and the client to ensure that all provider concerns are resolved in a timely and efficient manner
applies knowledge of established policies and procedures to resolve provider issues, and to work with the customer to ensure compliance
exercises independent judgment within defined practices and procedures to define appropriate actions

Requirements

What you’ll need

Three or more years of working in a provider relations or provider contracting role for a health plan in Medicaid or Medicare
Solid understanding of provider operations and key business transactions from a health plan, provider group, or government regulatory perspective
Experience working with medical claims processing and claims resolution
Strong analytical skills and provider relations skills
Excellent communication, presentation, and facilitation skills
Some training experience preferred
Experience working with business processes
Ability to assess clients' business and identify improvement opportunities
Willingness and ability to travel in the DC Metro area as needed

Benefits

Comp & perks

generous, flexible vacation policy
401(k) employer match
comprehensive health benefits
educational assistance
leadership and technical development academies