Medicaid Operations & Claims Assistant II

South Dakota AG; Sioux Falls (SD); In loco; USD 32.000 - 41.000; Tempo pieno

Vantaggi offerti da questo lavoro

Veterans’ Preference

Health insurance option

11 paid holidays

Vacation and sick leave

Retirement benefits

Descrizione del lavoro

South Dakota Department of Social Services is seeking an Operations Program Assistant II for the Medicaid program. The role focuses on providing high-quality customer service to Medicaid providers and supporting day-to-day data entry and claims processing operations.

The position involves reprocessing decisions, portal support, staff training, and data quality reporting. It requires strong communication skills and the ability to manage multiple tasks while meeting deadlines.

Competenze

• Experience in data entry, claims processing, or customer service.
• Medicaid, healthcare billing or medical claims experience preferred.

Mansioni

• Determine appropriateness of requests to reprocess claims.
• Approve or deny provider claim reconsideration requests through the Medicaid Online Portal.
• Monitor inquiries via the provider portal and DSS email system.
• Support training on claim entry into the Portal and direct advanced inquiries as needed.
• Compile and report data entry errors and communicate issues to leadership.
• Monitor daily claims and the workflow to ensure timely processing.

Conoscenze

Verbal communication

Written communication

Policy interpretation

Data gathering & analysis

Relationship building

Multitasking

Portal navigation

Independent work

Strumenti

Provider portals

Email systems

Data management tools

Descrizione del lavoro

South Dakota Department of Social Services is seeking an Operations Program Assistant II for the Medicaid program. The role focuses on providing high-quality customer service to Medicaid providers and supporting day-to-day data entry and claims processing operations.

The position involves reprocessing decisions, portal support, staff training, and data quality reporting. It requires strong communication skills and the ability to manage multiple tasks while meeting deadlines.