Data Entry, Processing, Review & Verification Specialist

Job Title:

Data Entry, Processing, Review & Verification Specialist Job Summary:

The Data Entry, Processing, Review & Verification Specialist is responsible for performing accurate data entry, claims processing, and verification activities. This role ensures data integrity, compliance with established policies, and timely completion of tasks while supporting provider enrollment processes and stakeholder communication.

Key Responsibilities:

Perform accurate and timely data entry of claims and related information. Review records and documentation to ensure completeness and accuracy. Process, review, and verify data using systems such as mainframe, Datacap, Provider Enrollment Portal, and File Director. Validate claims data (e.g., CMS-1500 and UB-04 forms) against multiple sources using manual and automated methods. Index and organize claims for efficient retrieval. Apply established policies and procedures during data processing and verification activities. Conduct quality control checks to ensure adherence to performance standards. Monitor work progress and ensure completion within established deadlines. Communicate with providers and stakeholders for outreach and issue resolution. Perform additional administrative and data entry tasks as assigned.

Required Qualifications:

Experience in data entry, document review, and data verification. Familiarity with claims processing and healthcare documentation (CMS-1500, UB-04). Proficiency in systems such as Datacap, Provider Enrollment Portal, and File Director. Strong understanding of policies, procedures, and quality control processes. Experience with provider enrollment and stakeholder communication. Ability to manage workload and meet deadlines efficiently. High attention to detail and accuracy.

Pay:

$22.00 - $30.00 per hour Application Question(s): Do you have hands-on experience working with healthcare claims such as CMS-1500 or UB-04 forms? Do you have experience using data entry or document processing systems (e.g., Datacap, provider portals, or similar tools)? Do you have professional experience verifying data against multiple sources with a high level of accuracy?

Work Location:

Hybrid remote in Pierre, SD 57501