• Actively contribute to the profitable growth of the business line through various mandates related to property and casualty insurance • Act as a trusted advisor to business development teams and take on a leadership role in strategic projects • Make strategic recommendations for the development and execution of complex projects • Monitor the growth and profitability of individual groups and the overall business sector • Diagnose issues and make recommendations • Advise and support business partners in positioning, planning, development, execution, and follow-up for various strategic projects • Contribute to team development through coaching

• Maintains accurate and current files and databases • Manages RMIS (RisKonnect) and is subject matter expert • Serves as liaison between OH BWC and SP • Maintains SharePoint site • Subject matter expert for patient compensation funds • Participates in reconciling audits performed by insurance carriers and is familiar with large retention insurance programs across multiple lines of coverage • Functions as an insurance liaison, advisor and resource person for department administrators, and other personnel • Oversee the processing of insurance claims, ensuring that all claims are handled efficiently, accurately, and in compliance with applicable laws and regulations • Proactively manages claims from start to finish, identifying any potential issues or delays, financial implications, and ensuring timely resolution • Identifies area for process improvement and risk mitigation

• Review incoming insurance applications to ensure accuracy, completeness, and compliance • Communicate application status clearly and professionally with agents, carriers, and internal stakeholders • Maintain thorough and compliant electronic case files from submission through policy issuance • Enter and audit data within applicable administrative systems • Order, track, and retrieve underwriting requirements • Coordinate suitability approvals and agent signatures to ensure regulatory compliance • Follow up proactively and provide timely case status updates • Prepare policies for issuance, assemble policy documents, and secure final delivery requirements • Apply working knowledge of insurance laws, rules, and regulations • Serve as a system and process resource for team members • Perform administrative functions such as imaging, faxing, copying, and filing • Consistently meet or exceed departmental quality and productivity standards

Role Description Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. The role of the Provider Field Service Representative (FSR) is to act as a liaison between Gainwell Technologies, Nevada Medicaid/ Nevada Health Authority (NVHA), and the Medicaid provider community. - Support providers with claims, enrollment, prior authorizations, and related research - Resolve escalations and handle complex or unique issues independently - Conduct provider outreach (welcoming, corrections, reminders) and build strong relationships - Deliver trainings/workshops (1:1 and group) and present at association meetings and Medicaid conferences - Develop training materials and presentations - Identify process improvements and apply sound judgment within established policies Qualifications - Bachelor’s degree or equivalent healthcare experience required - Minimum 2 years’ experience with Medicaid, Medicare, or commercial insurance - Knowledge of Medicaid processes, including enrollment, authorizations, claims, and payments - Experience in healthcare and/or training facilitation - Strong written and verbal communication skills - Excellent customer service skills - Successful completion of Nevada fingerprinting and federal background check Requirements - Remote position, MUST be able to work 8-5 PST - Ability to travel as needed (up to 10%) Benefits - Generous, flexible vacation policy - 401(k) employer match - Comprehensive health benefits - Educational assistance - Leadership and technical development academies to help build your skills and capabilities