Healthcare Claims Assistant
DataStaff is in immediate need of a Healthcare Claims Assistant for one of our direct clients in the Raleigh, NC area for a long-term contract opportunity.
This role will be HYBRID. You will report to the onsite 2 days a month. All other days are remote.
Responsibilities:
- Process provider enrollment applications to ensure new and currently enrolled providers are within compliance within regulations.
- Validate the qualifications of licensed professionals, organizational members or organizations
- Render a determination that an organization or entity meets the established qualifications, requirements and/or standards to provide a service or procedure as outlined in the State business rules/desk procedures.
- Perform and assess the background check through Lexis Nexis, AAR and PPTD.
- Perform source verification of licensure, certification, endorsements and accreditation's through Lexis Nexis or State Licensure Board.
- Deny providers that do not meet the requirements.
- Meet performance quality standards on a daily basis.
- Meet performance quantity standards on a daily basis.
Required Skills:
- Requires 2 years administrative experience
- Knowledge of NC Medicaid or Healthcare
- Working knowledge of NCTracks
- Working knowledge of provider enrollment requirements
- Proficient with Microsoft suite
Desired Skills:
- Credentialing experience
- Customer service experience
- Experience working with fax machines, computer software, and telephone technology
- Attention to detail
- Strong verbal and written communication
- Ability to follow oral and written directions
This opportunity is available as a W2 position with a competitive benefits package. DataStaff, Inc. offers medical, dental and vision coverage options as well as paid vacation, sick and holiday leave. As many of our opportunities are long-term, we also have a 401K program available for employees after 6 months.