Provider Revalidation Field Representative - Louisiana

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. The Provider Revalidation Field Representative partners directly with healthcare providers to drive successful completion of provider enrollment and revalidation activities. This role serves as a trusted resource, helping providers navigate Medicaid participation requirements, maintain regulatory compliance, and avoid disruptions in reimbursement or network participation.

Responsibilities

• 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

• 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.

Skills

• Strong verbal and written communication skills.
• Strong organizational, analytical, and problem-solving skills.
• Proficiency with Microsoft Office applications.

Benefits

• Support critical provider revalidation initiatives that help ensure continued access to care for Medicaid members.
• Build relationships with healthcare providers and serve as a trusted resource throughout the enrollment and revalidation process.
• Collaborate with Provider Enrollment, Operations, Compliance, Quality Assurance, and Client teams to improve provider participation and compliance outcomes.
• Receive training on state-specific provider enrollment and revalidation requirements to support provider success and compliance.

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

Full-time schedule is typically 40 hours per week.