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Provider Field Representative

Remote · USA Full-time New today

General Profile Performs routine and structured assignments related to provider support and Medicaid operations. Develops skills through hands‑on work with providers, systems, and internal teams. Uses established procedures to resolve routine or standard provider inquiries. Receives instruction, guidance, and direction from more experienced team members or leadership. Responsibility Statements Serves as a primary point of escalation contact for NH Medicaid providers regarding claims, enrollment, billing, and portal-related inquiries. Builds and maintains strong, positive relationships with providers and the client to support program success. Assists in overall business unit performance by supporting provider satisfaction and operational accuracy. Ensures adherence to best practices and compliance with NH Medicaid policies and the Statement of Work. Conducts MMIS portal training for providers, including navigation, claims submission, eligibility verification, and reporting tools. Acts as a liaison between providers, operations, and state partners to ensure protocols are followed and issues are resolved. Supports conflict resolution related to provider concerns, claims disputes, or enrollment challenges. Manages provider, system, and task-related issues with professionalism and accuracy. Provides resolutions for a diverse range of tasks, including:Claims troubleshooting Enrollment and revalidation support Portal access and technical guidance Policy clarification Special projects Urgent provider needs Drives special projects for operational, state, or provider initiatives. Performs other duties as assigned. Complies with organizational policies, state requirements, and operational standards. Applies knowledge of NH Medicaid operations, provider relations, and healthcare business practices gained through education or prior experience. Understands how provider performance and compliance impact program outcomes. Uses established procedures to resolve standard provider issues related to claims, enrollment, billing, and portal access. Examines information, policies, and standard practices to make sound judgments and escalate issues appropriately. Communicates clearly and professionally with providers, internal teams, and state partners. Builds and maintains positive working relationships with providers and the client. Exchanges information and ideas effectively. Asks clarifying questions and checks for understanding to ensure accurate guidance. REQUIREMENTS College degree or equivalent work experience required, with exposure to healthcare operations, Medicaid programs, or related concepts. Requires relevant expertise in Medicaid operations, provider relations, claims processes, or technical program support, gained through formal education or equivalent experience. Additional Skills preferred: Requires a conceptual understanding of NH Medicaid policies, claims processes, provider enrollment procedures, and MMIS portal functionality. Understands provider types, billing practices, and Medicaid program requirements. Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated salary range for this role is $58,000-$65,000 Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day. Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law. For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form. Complete the form and then email it as an attachment to [email protected]. You may also click here to access Conduent's ADAAA Accommodation Policy. Apply To This Job

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