[Remote] Provider Claims Training Specialist - San Diego, CA - Remote

Note: The job is a remote job and is open to candidates in USA. Gainwell Technologies is a company that values contributions and offers career growth opportunities. The Provider Claims Training Specialist supports the provider community by delivering training and acting as a liaison between providers and internal departments, ensuring compliance with program policies.

Responsibilities
• Under minimal supervision, performs routine to complex tasks that are related to provider claiming, program policies, and training
• Provides training (workshops, seminars, program specific group events) to the provider community and acts as liaison with our internal departments and the customer to implement programs that are necessary for the Medicaid program
• Provides one-on-one billing support, claim research and analysis, and targeted outreach to providers; supports provider association inquiries and events
• Applies knowledge of established policies and procedures to resolve provider issues, and to work with the customer to ensure compliance
• Exercises independent judgment within defined practices and procedures to define appropriate actions; escalates areas of concern to leadership/the client as defined by procedures; evaluates unique circumstances and makes recommendations

Skills
• Three or more years of medical claims processing or provider billing experience, including working knowledge of CMS-1500 and UB-04 claim forms
• Hands-on experience researching, resolving, and educating providers on claim submission, denials, and reimbursement processes; Medi-Cal or Medicaid experience preferred
• Strong analytical, organizational, and time management skills, with proven ability to manage multiple provider requests efficiently
• Excellent communication, presentation, and training skills for both virtual and in-person settings, with a focus on simplifying complex billing and policy topics
• Willingness and ability to travel within the assigned region to conduct provider visits, outreach events, and training sessions
• Medi-Cal or Medicaid experience preferred

Benefits
• Generous, flexible vacation policy
• A 401(k) employer match
• Comprehensive health benefits
• Educational assistance
• Variety of leadership and technical development academies

Company Overview
• Gainwell Technologies is a provider of Information Technology & Services. It is a sub-organization of Veritas Capital. It was founded in 2009, and is headquartered in Irving, Texas, USA, with a workforce of 10001+ employees. Its website is https://www.gainwelltechnologies.com/.

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