Claims, Advice and Processing Specialist

Job ID: 27011
Agency: Department of Social Services / Division of Medical Services
Location: Pierre
Salary: $18.25 per hour
Pay Grade: GE
Closing Date: 05.29.2024

This is a Full-Time position with the Department of Social Services Division of Medical Services. For more information on the DSS, please visit https://dss.sd.gov.

This position is responsible for assisting medical providers and recipients with their Medicaid claims. Duties include responding to calls from Medicaid providers and recipients to identify and resolve issues related to submitted claims. In addition, this position identifies and resolves errors on Medicaid claims that have been submitted.

The Ideal Candidate Will Have:
Experience in customer service position and processing medical claims.

Knowledge, Skills, Abilities:

• mathematical calculation methods;
• medical billing and coding knowledge (preferred but not required, will train);
• claims processing practices and procedures (preferred but not required, will train);
• demonstrate customer service, compassion, respect, courtesy, and tact when interacting with others;
• communicate information clearly and concisely, including obtaining and providing information by phone in a courteous manner;
• plan and organize work to meet schedules and deadlines and respond and adjust to multiple demands;
• take steps to effective resolve problems in conflict situations.

This position is eligible for Veterans’ Preference per ARSD 55:10:02:08.

NCRC: If you possess a National Career Readiness Certificate, please submit the certificate with your application. For more information on how to acquire a National Career Readiness Certificate contact a South Dakota Department of Labor and Regulation Job Service Office. A certificate is not necessary to be considered.

The State of South Dakota does not sponsor work visas for new or existing employees. All persons hired will be required to verify identity and eligibility to work in the United States and complete an Employment Eligibility Verification, Form I-9. The State of South Dakota as an employer will be using E-Verify to complete employment eligibility verification upon hire.

The State of South Dakota offers employer paid health insurance plus eleven paid holidays, generous vacation and sick leave accrual, dental, vision, and other insurance options, and retirement benefits. You can view our benefits information at https://bhr.sd.gov/job-seekers/work-for-state-government/. This position is a member of Class A retirement under SDRS.

Must apply online: https://sodakprod-lm01.cloud.infor.com:1443/lmghr/xmlhttp/shorturl.do?key=PS1
You must apply online, emailed resumes or submissions will not be accepted.
South Dakota Bureau of Human Resources
Telephone: 605.773.3148 Email: careers@state.sd.us
http://bhr.sd.gov/workforus
"An Equal Opportunity Employer"