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City: Lincoln State: NE Category: 13-1000 Occupation: 13
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Skills: MS Excel, MS Office, MS Outlook, MS PowerPoint, MS Word Requirement: Required Credentials and Experience:
7+ years direct experience with Medicaid fee for service and managed care encounter claim processing.
In-depth knowledge and technical understanding of the various segments of healthcare X12 837P/I/D EDI formats.
Expert knowledge of healthcare industry claim coding standards.
Microsoft Word (creating, editing, and saving documents), Microsoft Outlook (email and calendar management), Microsoft PowerPoint (creating, editing and presenting slide decks) and Microsoft Excel (filtering, sorting and editing data in spreadsheets, formulas, and creating pivot tables).
Analysis and problem-solving skills to resolve operational problems and improve reporting performance. Description: All Openings https://www.jobshorn.com/company/sohanit-inc/jobs
Job Description
Medicaid Encounter Claim Processing and Reporting Subject Matter Expert (SME)
This position directly supports the State of Nebraska’s Medicaid program. Key job activities will be providing expertise and recommendations on strategies for monitoring and continually improving Medicaid encounter data. This position provides flexible part time work hours and is a fully remote position.
Job Responsibilities:
Serve as the subject matter expert in Medicaid encounter claim processing and reporting.
Provide expert level encounter transaction knowledge that includes HIPAA x12 837 and NCPDP claim requirements, as well as the end-to-end processes. (from the managed care plan(s) healthcare claim processing systems to the state’s data warehouse, CMS T-MSIS reporting files and other downstream reports)
US local resources, Work authorization required, Work authorization sponsored, Work authorization in field of study
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