United States onlySummary
The role of the Provider Field Representative (PFR) is to function as a liaison between HMS, Alaska Health Care Services, and the Medicaid provider community within the state. The PFR must be able to work independently while meeting short deadlines and ensuring timely communications with all parties. PFRs must present professionally in all interactions with stakeholders. The PFR position reports directly to the Member Provider Manager. The PFR is responsible for representing HMS and HCS when assisting providers.
Your role in our mission
- Assisting providers with investigation of routine and complex claims, enrollment, or other challenges.
- Conducting outreach to offer corrections, invite providers to submit missing information needed to process their requests, offer reminders, Etc.
- Developing relationships within the provider community.
- Facilitating training workshops.
- Collaborating with the customer and provider community to grow participation in the Alaska Medicaid program.
- Exercising independent judgment within generally defined policies and practices to identify and select a solution.
- Evaluating unique circumstances and making recommendations.
What we're looking for
- Two years' healthcare experience working with Medicaid/Medicare or commercial insurance.
- Excellent written and oral communication skills.
- Customer Service skills.
- Experience presenting to/training in individual and group settings.
- Ability to travel within the state as needed.
Preferred Experience
- Understanding of Medicaid processes: enrollment, authorizations, claims, and payments.
What you should expect in this role
Work-from-home (WFH); or Hybrid model including in-office and WFH days to be defined. 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 work efforts.
This posting is intended for pipelining. We will accept applications on an ongoing basis.
The pay range for this position is $44,800 - $64,000 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 HMS , a Gainwell Company . 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.
We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with HMS , a Gainwell Company , an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about HMS , A Gainwell Technologies Company at our company website and visit our Careers site for all available job role openings.
HMS, a Gainwell Company, 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. HMS 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.
Nearest Major Market: Alaska
Nearest Secondary Market: Anchorage
