Provider Revalidation Field Representative - Colorado

Summary

The Provider Revalidation Field Representative serves as the primary liaison between Gainwell, state Medicaid programs, and the provider community. This role supports provider enrollment and revalidation initiatives to ensure healthcare providers remain compliant with CMS, state, and federal participation requirements.

Responsibilities

• Conduct proactive outreach to healthcare providers regarding enrollment, revalidation requirements, deadlines, and compliance expectations.
• Serve as the primary point of contact for providers throughout the revalidation process, ensuring timely completion of required documentation and corrective actions.
• Research and resolve provider inquiries related to enrollment, revalidation, credentialing, participation requirements, claims, and billing operations.
• Deliver provider education through individual consultations, webinars, workshops, presentations, and outreach activities designed to improve provider engagement and compliance.
• Monitor provider participation and revalidation progress while collaborating with internal teams to improve completion rates and provider satisfaction.

Requirements

• Two (2) or more years of experience in provider enrollment, provider relations, credentialing, healthcare operations, medical billing, customer service, Medicaid, Medicare, or a related healthcare environment.
• Experience working with healthcare providers, physician offices, clinics, hospitals, behavioral health providers, long-term care facilities, or other healthcare organizations.
• Strong verbal and written communication skills with the ability to educate providers, build professional relationships, and deliver excellent customer service.
• Strong organizational, analytical, and problem-solving skills with the ability to manage multiple priorities and deadlines.
• Proficiency with Microsoft Office applications, including Excel, Outlook, Word, and Teams.

Qualifications

• Must be able to travel within assigned territories based on project and business needs.

Skills

• Excellent communication and interpersonal skills.
• Ability to work independently and as part of a team.
• Strong organizational and time management skills.
• Knowledge of Medicaid, Medicare, and related healthcare regulations.

Benefits

Gainwell Technologies offers a competitive compensation package, including a base pay range of $35,000 - $50,000 per year, with the actual salary offered varying based on geographic location, internal equity, and other factors. The company provides a comprehensive benefits package, including:

• Flexible vacation policy
• 401(k) employer match
• Comprehensive health benefits
• Education assistance

Gainwell Technologies is committed to fostering an inclusive workplace and is an Equal Opportunity Employer. We value diversity and are dedicated to creating an environment where all employees feel valued and respected.