About The Opportunity

This position will serve as a member of the Business Technology Relationship Management team. The unit is responsible for managing relationship between the DHB program/functional areas and the Technology that supports the business and division.

Job Description

• This position will serve as a member of the Business Technology Relationship Management team. The unit is responsible for managing relationship between the DHB program/functional areas and the Technology that supports the business and supports all of the division.
• Review of various claims reports to perform in-depth claim analysis, validation of system changes, and review of edits/audits in order to make recommendations to maintain the integrity of the reprocessing.
• Provide incident monitoring, problem ticket, incident creation and troubleshooting.
• Defect Resolution
• Requesting System Enhancements

Required Skills

• Experience working with NC Medicaid
• Experience with NCTracks
• Experience with gathering requirements
• Experience working with claims adjudication/reprocessing
• An understanding of claim edits and audits
• Strong understanding of health care strategy, operations, technology, and regulatory requirements
• Demonstrated ability to work independently in a fast-paced environment with concurrent deadlines
• Excellent communication, negotiation, conflict resolution and persuasion abilities
• Strong organizational, time management, communication, and detail-oriented skills
• Highly proficient with Microsoft Outlook, Word and Excel

Duration

12 Months