Provider Field Representative - Southern California Region

Provider Field Representative - Southern California Region Date: Apr 9, 2026 Location: Any city, CA, US, 99999 Work Mode: Virtual (Exception only) Summary 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. Your role in our mission 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. What we’re looking for 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; working knowledge of CMS‑1500 and UB‑04 claim forms preferred. Demonstrated ability to work independently and exercise sound judgment when handling sensitive or escalated customer service issues. Hands‑on experience researching, resolving, and educating providers on claims processing, billing, and reimbursement; Medi‑Cal or Medicaid experience preferred. 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. What you should expect in this role Must be a resident of the state of California, with primary residence in Southern California (Ventura, Los Angeles, Orange, or San Bernardino counties). Travel required throughout one or more geographic regions to support outreach, training and other provider and account needs. For positions assigned to WFH, reliable high‑speed internet connectivity is required. Employees working‑from‑home may be required to report to the office, at times, to support meetings, special training requests or other business needs. The office is in West Sacramento. The pay range for this position is $70,000 - $72,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job‑related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full‑time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities. Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.” #J-18808-Ljbffr