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)

Duration: 36 months (June 1, 2026 – May 31, 2029)

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

Provider Enrollment Portal

File Director

Process, review, and verify claims data against multiple sources

Work with healthcare claim forms including:

CMS-1500

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

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

Experience working in secure, compliance-driven environments

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