Healthcare Claims Assistant

Job Title

The Medical / Dental Prior Approval Division provides medical necessity reviews and service determinations for NC Medicaid in accordance to Clinical Coverage Policies. This position is for full time employment Monday - Friday and will be a hybrid work environment.

Responsibilities :

• Processing orthodontic prior approval cases : preparing all documentation and orthodontic study models for review (this includes researching recipient Medicaid eligibility; researching prior approval history; printing and organizing all required documents; keying case review outcomes; tracking orthodontic inventory; preparing cases to return to orthodontic providers).

Required Skillset :

Work Environment :

Additional information :

The likely hourly rate for this position is between $17.22 - $23.00. This is not, however, a guarantee of compensation or salary. Rather, salary will be set based on experience, geographic location and possibly contractual requirements and could fall outside of this range.

Scheduled Weekly Hours : 40

Travel Required : None

Telecommuting Options : Hybrid

Work Location : USA NC Raleigh - 5444 Wade Park Blvd (NCS018)