Claims Data Entry
Posted 2 weeks ago by Techgene Solutions LLC
Negotiable
Undetermined
Hybrid
Remote or Pierre, South Dakota
Summary: The Claims Data Entry role involves data entry, processing, review, and verification of claims and related records. The position requires utilizing various systems to ensure accuracy and compliance in documentation. The candidate will also engage in provider outreach and support additional administrative tasks as needed. This role is based in Pierre, South Dakota, with the possibility of remote work.
Key Responsibilities:
- Perform data entry and processing of claims and related records
- Review and validate documentation for accuracy and completeness
- Utilize systems such as:
- Mainframe systems
- Datacap
- Provider Enrollment Portal
- File Director
- Verify data against multiple sources (manual and system-based validation)
- Work with claims documents including:
- CMS-1500
- UB-04 (CMS-1450)
- Index and organize claims documentation
- Apply policies and procedures to ensure compliance in processing and verification
- Conduct quality control checks to ensure adherence to standards
- Perform provider and stakeholder outreach as needed
- Monitor and ensure completion of tasks within defined timelines
- Support additional administrative and data-related tasks as assigned
Key Skills:
- Proven experience in data entry, processing, and verification tasks
- Strong familiarity with claims processing and healthcare documentation
- Experience using systems such as Datacap, Provider Enrollment Portal, and File Director
- Knowledge of CMS-1500 and UB-04 (CMS-1450) claim forms
- Understanding of data verification processes, policies, and quality control standards
- Ability to meet strict deadlines and productivity targets
- Strong attention to detail and accuracy
- Experience in provider enrollment and stakeholder outreach processes
Salary (Rate): undetermined
City: Pierre
Country: United States
Working Arrangements: hybrid
IR35 Status: undetermined
Seniority Level: undetermined
Industry: Other
Data Entry, Processing, Review & Verification and Associated Tasks
Location: Pierre, South Dakota
Contract Duration:
Key Responsibilities
- Perform data entry and processing of claims and related records
- Review and validate documentation for accuracy and completeness
- Utilize systems such as:
- Mainframe systems
- Datacap
- Provider Enrollment Portal
- File Director
- Verify data against multiple sources (manual and system-based validation)
- Work with claims documents including:
- CMS-1500
- UB-04 (CMS-1450)
- Index and organize claims documentation
- Apply policies and procedures to ensure compliance in processing and verification
- Conduct quality control checks to ensure adherence to standards
- Perform provider and stakeholder outreach as needed
- Monitor and ensure completion of tasks within defined timelines
- Support additional administrative and data-related tasks as assigned
Required Qualifications
- Proven experience in data entry, processing, and verification tasks
- Strong familiarity with claims processing and healthcare documentation
- Experience using systems such as Datacap, Provider Enrollment Portal, and File Director
- Knowledge of CMS-1500 and UB-04 (CMS-1450) claim forms
- Understanding of data verification processes, policies, and quality control standards
- Ability to meet strict deadlines and productivity targets
- Strong attention to detail and accuracy
- Experience in provider enrollment and stakeholder outreach processes
Preferred Qualifications
- Prior experience working with government agencies or Medicaid/healthcare systems
- Experience supporting DSS or similar state programs
- Ability to scale work efforts based on workload demands
- Familiarity with HIPAA compliance and data security requirements
Core Competencies
- High attention to detail and accuracy
- Strong organizational and time management skills
- Ability to follow structured processes and procedures
- Analytical thinking and problem-solving
- Effective communication for stakeholder interaction
- Quality-focused mindset