Provider Field Representative I

The Provider Field Representative I supports New Hampshire Medicaid providers by resolving routine inquiries, delivering MMIS portal guidance, and helping ensure provider satisfaction, operational accuracy, and program compliance. 

General

• Performs routine provider support and Medicaid operations activities using established processes and procedures.

• Develops job knowledge and skills through hands-on experience, training, and collaboration with providers and internal teams.

• Resolves standard provider inquiries and issues with guidance from leadership and experienced team members.

• Supports provider satisfaction, operational excellence, and program compliance.

Responsibilities

• Serve as a primary point of contact for New Hampshire Medicaid providers regarding claims, enrollment, billing, and MMIS portal inquiries.

• Build and maintain positive working relationships with providers, state partners, and client stakeholders.

• Conduct provider training on MMIS portal functionality, including claims submission, eligibility verification, enrollment and revalidation activities, and reporting tools.

• Act as a liaison between providers, operations teams, and state partners to facilitate issue resolution and ensure adherence to established processes.

• Research, troubleshoot, and resolve routine provider issues related to claims processing, provider enrollment and revalidation, portal access and navigation, billing inquiries, and policy guidance.

• Escalate complex issues appropriately and follow through to resolution.

• Support provider outreach initiatives, operational improvements, and special projects as assigned.

• Assist in resolving provider concerns, disputes, and service-related issues in a professional and timely manner.

• Apply working knowledge of Medicaid operations, provider relations, and healthcare business practices to support program objectives.

• Analyze information, policies, and procedures to make sound recommendations and decisions within established guidelines.

• Communicate effectively with internal and external stakeholders, ensuring accurate and consistent information is provided.

• Maintain compliance with contractual requirements, state regulations, organizational policies, and operational standards.

• Perform other duties as assigned.

Qualifications

• A minimum of three (3) years of experience in healthcare operations, Medicaid programs, provider relations, claims processing, customer service, or technical program support.

• Minimum of one (1) year of training development, facilitation, or provider education experience.

• Strong analytical, problem-solving, critical thinking and customer service skills.

• Excellent verbal and written communication skills.

• Proficiency with Microsoft 365 applications, including Outlook, Word, Excel, PowerPoint, and Teams.

• Ability to manage multiple priorities and work effectively in a fast-paced environment.

Preferred Qualifications

• Knowledge of New Hampshire Medicaid policies, provider enrollment processes, claims adjudication, and reimbursement methodologies.

• Experience using Medicaid Management Information Systems (MMIS) or similar healthcare systems.

• Understanding of provider billing practices, healthcare regulations, and Medicaid program requirements.

• Experience supporting healthcare providers through training, outreach, or account management activities.

• Have an associate’s degree.

Flexible Working

At Conduent, we want you to be yourself. We recognize that everyone is different and that how people want to work and deliver at their best is different for everyone too.

In this role, you can expect the following working conditions:

• Onsite work: Work in our local office, receiving personal coaching and leadership so that you can provide the best support to our clients and help you grow in your career.

Working For You

Perks and rewards designed for you:

• Health and Welfare Benefits: Our health and welfare benefits can be tailored to fit you and your family's needs and start on the first day of employment.
• Retirement Savings: We will support you as you save for your future.
• Employee Discounts: We offer you access to a vast selection of global, national, and local discounts on merchandise, services, travel, and more.
• Career Growth Opportunities: We help you thrive, so together, we can grow. We provide opportunities to advance your career with a vast portfolio of businesses and a global footprint.
• Paid Training: Earn while you learn and continue to grow with access to award-winning learning platforms throughout your Conduent career.
• Paid time off: We provide attractive paid time off packages designed for you to enjoy your life away from work.
• Great Work Environment: We are proud of our award-winning culture and the recognition we’ve received for our diversity efforts.

Join Us

At Conduent, we are one team, one mission. We understand that our success is directly related to the success of our associates. 

We strive to create a culture where you can:

• Bring your authentic self to work.
• Grow and thrive, both personally and professionally.
• Make a difference with our clients, in our communities, and with the millions of people we support.

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 $47,740 - $62,000.