Claims And Encounter Technical Analyst

NC Department of Health and Human Services

North Carolina, USA
Recruitment range: $67,122 - $95,639; grade range:...
Hybrid
Medicaid direct and encounter claims resolution
Understand business and medicaid processes
Technical expertise with medicaid claims
The position will serve as a technology liaison for the Managed Care Business Operations team in order to assist with the resolution of Medicaid direct and encounter claims

Job Summary

  • The position will serve as a technology liaison for the Managed Care Business Operations team in order to assist with the resolution of Medicaid direct and encounter claims.
  • This position will be responsible for planning, organizing, requirements definition, change service request (CSR) generation, defect identification and management, training and testing.
  • The State of North Carolina offers excellent comprehensive benefits, including health insurance options, retirement plans, NCFlex program, paid leave, and parental leave.

Matching Summary

The position will serve as a technology liaison for the Managed Care Business Operations team in order to assist with the resolution of Medicaid direct and encounter claims.

Salary

Recruitment Range: $67,122 - $95,639; Grade Range: $67,122 - $117,465; Benefits: Comprehensive state benefits

Skills & Requirements

Must-have

  • Medicaid direct and encounter claims resolution
  • Understand business and Medicaid processes
  • Technical expertise with Medicaid claims
  • Work with technical staff and internal teams
  • Defect identification and management
  • Planning, organizing, requirements definition

Nice-to-have

  • Federal managed care requirements knowledge
  • Identify and resolve business technology issues
  • Oversight of Encounter Processing System
  • Evaluate and troubleshoot data challenges
  • Recommend process and system improvements

Key Requirements

  • Bachelor's degree or equivalent combination of training and experience
  • Three years of programmatic experience related to the area of assignment

Work Rights

Not specified

Tailored Resume

Cover Letter