Provider Revalidation Field Representative - Delaware

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 attention to detail and organizational skills.
• Knowledge of Medicaid and Medicare regulations and procedures.

Benefits

Gainwell Technologies offers a competitive compensation package, including a base salary range of $35,000 - $50,000 per year, with the actual salary determined by geographic location, internal equity, and other factors. Salaried, full-time employees are eligible for a generous vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. Additional benefits include a variety of leadership and technical development academies to enhance skills and capabilities.

Pay

The pay range for this position is $35,000 - $50,000 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Schedule

Flexible scheduling is offered to accommodate the needs of both the employee and the organization.