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

Claims Data Entry

Key skills