Data Entry & Claims Processing Specialist

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Job Description

Data Entry & Claims Processing Specialist
Location: Remote / Hybrid (with potential onsite or virtual collaboration; support presence in Pierre & Rapid City, SD preferred)
Duration: 36 months (June 1, 2026 – May 31, 2029)

Job Summary
The Data Entry & Claims Processing Specialist will support by performing high-volume data entry, claims processing, verification, and quality control activities. This role requires strong attention to detail, familiarity with healthcare claims documentation, and experience working with multiple data systems while ensuring compliance with policies and HIPAA standards.

Key Responsibilities
Perform accurate and timely data entry and processing tasks
Review records and documentation for completeness and accuracy
Utilize systems such as:
Mainframe systems
Datacap
Provider Enrollment Portal
File Director
Process, review, and verify claims data against multiple sources

Work with healthcare claim forms including:
CMS-1500
UB-04 (CMS-1450)
Index and organize claims documentation
Apply policies, procedures, and protocols in all activities
Conduct manual and system-based verification of claim data
Perform quality control checks to ensure compliance and accuracy
Monitor task completion and meet established deadlines
Support provider and stakeholder outreach and communication
Handle additional administrative and data-related tasks as assigned

Required Skills & Qualifications
Experience in data entry, processing, and verification roles
Strong knowledge of healthcare claims processing

Familiarity with:
CMS-1500 and UB-04 claim forms
Datacap, Provider Enrollment Portal, and File Director
Understanding of data verification processes and quality control standards
Knowledge of provider enrollment processes and stakeholder outreach
Strong attention to detail and accuracy
Ability to manage workload and meet deadlines consistently
Familiarity with HIPAA compliance and data security standards

Preferred Qualifications
Prior experience working with similar government agencies
Experience in Medicaid or healthcare-related systems
Ability to scale work efforts based on project needs
Experience working in secure, compliance-driven environments

Soft Skills
Strong organizational and time management skills
Excellent communication skills (written and verbal)
Problem-solving and analytical thinking
Ability to work independently and collaboratively
High level of accountability and reliability

Job Information

Rate / Salary

$ - $

Sector

Not Specified