Data Entry / Compliance Officer

Tahche Outsourcing Services Inc; Colorado; Remote; USD 45,000 - 60,000; Full time

Job summary

A US-based insurance company is seeking a meticulous Claim Auditor to conduct daily pre-claim submission reviews of Medicaid trip claims. Responsibilities include reviewing and auditing spreadsheets, ensuring accuracy, and validating claims against compliance standards. The ideal candidate demonstrates strong attention to detail and proficiency in spreadsheets, alongside excellent organizational skills. This role requires self-motivation and the ability to work independently in a remote environment.

Qualifications

• Familiarity with regulatory or documentation guidelines relevant to the industry is a plus but not required.
• Strong attention to detail with a high level of accuracy in data handling.
• Proficient in using spreadsheets (Google Sheets or Microsoft Excel) for data input and tracking.
• Excellent organizational and time management skills to meet deadlines.
• Self-motivated and able to work independently in a remote setup.

Responsibilities

• Review and audit Medicaid Trip Spreadsheet and associated forms.
• Ensure required fields are complete and accurate, including Member ID, driver and vehicle information, pickup/drop-off details, and signatures.
• Validate claims against audit standards and regulatory requirements set forth by the Colorado Department.
• Track and report claim status changes, including reclassified denied claims.
• Prepare monthly audit reports detailing total claims reviewed, status breakdown, and resolution of outstanding denied claims.
• Ensure turnaround times for daily claim audits are met.

Skills

Attention to detail

Data handling accuracy

Proficient in spreadsheets

Organizational skills

Time management

Self-motivated

Job description

About the job Data Entry / Compliance Officer

A US-based insurance company is seeking a meticulous and experienced Claim Auditor to conduct daily pre-claim submission reviews of Medicaid Non-Emergency Medical Transportation (NEMT) trip claims. The auditor will evaluate submitted trip documentation for compliance with state regulations and internal policies before claims are submitted to the Colorado Departments provider payment portal. This role plays a key part in ensuring data accuracy, regulatory compliance, and timely reimbursement for transportation services provided to eligible members.

DUTIES AND RESPONSIBILITIES:

Review and audit Medicaid Trip Spreadsheet and associated forms

• Ensure required fields are complete and accurate, including Member ID, driver and vehicle information, pickup/drop-off details, and signatures
• Validate claims against audit standards and regulatory requirements set forth by the Colorado Department

Track and report claim status changes, including reclassified denied claims

• Maintain and update Auditor Monitoring Columns in the Trip Spreadsheet to reflect audit results
• Prepare monthly audit reports detailing total claims reviewed, status breakdown, and resolution of outstanding denied claims

Ensure turnaround times for daily claim audits are met

QUALIFICATIONS:

• Familiarity with regulatory or documentation guidelines relevant to the industry is a plus but not required

Strong attention to detail with a high level of accuracy in data handling

• Proficient in using spreadsheets (Google Sheets or Microsoft Excel) for data input and tracking

Excellent organizational and time management skills to meet deadlines

Self-motivated and able to work independently in a remote setup

• Willing to use personal computer and stable internet connection for remote work