Medicaid Operations Assistant II - Data Entry & Claims

South Dakota State Government; Pierre (SD); On-site; USD 32,000 - 41,000; Full time

Benefits offered by this job

Health insurance option

Eleven paid holidays

Vacation and sick leave accrual

Dental insurance

Vision insurance

Retirement benefits

Job summary

South Dakota State Government is seeking an Operations Program Assistant II for the Medicaid program in Pierre, SD or Sioux Falls, SD. This role focuses on high-quality customer service to Medicaid providers and day-to-day operations support of the Data Entry team.

Responsibilities include processing claims, approving or denying reconsideration requests through the Medicaid Online Portal, and responding to inquiries.

Qualifications

• Experience in data entry, claims processing, or customer service is preferred.
• Experience with Medicaid, healthcare billing or medical claims is preferred but not required.
• Ability to accurately interpret policies to determine claim outcomes.

Responsibilities

• Determine appropriateness of requests to reprocess claims and approve/deny provider reconsiderations.
• Monitor inquiries via provider portal and DSS email system.
• Support training on claim entry into the Portal.
• Compile and report data entry errors and communicate issues to leadership.
• Monitor daily claims and workflow to ensure timely processing.

Skills

Data entry

Claims processing

Customer service

Policy interpretation

Data analysis

Communication

Multitasking

Provider portals

Tools

Medicaid Portal

Email systems

Data management tools

Job description

South Dakota State Government is seeking an Operations Program Assistant II for the Medicaid program in Pierre, SD or Sioux Falls, SD. This role focuses on high-quality customer service to Medicaid providers and day-to-day operations support of the Data Entry team.

Responsibilities include processing claims, approving or denying reconsideration requests through the Medicaid Online Portal, and responding to inquiries.