Data Entry & Claims Processing Specialist

Data Entry & Claims Processing Specialist Location: Remote / Hybrid (with potential onsite or virtual collaboration; support presence in Pierre & Rapid City, SD preferred) 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, and File Director. Process, review, and verify claims data against multiple sources. Work with healthcare claim forms including CMS-1500 and 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. Familiarity with 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. 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. J-18808-Ljbffr