Healthcare Claims Examiner Dental Hygienist

Type of Requisition:

Regular

Clearance Level Must Currently Possess:

None

Clearance Level Must Be Able to Obtain:

None

Public Trust/Other Required:

None

Job Family:

Healthcare Claims

Job Qualifications:

Skills:

Dental Hygiene, Microsoft Office, Teamwork

Certifications:

None

Experience:

5 + years of related experience

US Citizenship Required:

No

Job Description:

GDIT NCMMIS is a claims processing system for the North Carolina Department of Health and Human Services (NC DHHS) to which North Carolina citizens have become entitled through enrollment in benefit plans offered by the State of North Carolina.

The program is seeking a Dental Prior Approval Reviewer to analyze dental prior approval requests for North Carolina Medicaid to ensure compliance with organizational and governmental guidelines.

Qualifications

• Current North Carolina Dental Hygiene license in good standing.
• 5+ years of clinical dental hygiene experience.
• Medicaid or public healthcare experience a plus.
• Experience using NCTracks is a plus.

Key Job Responsibilities

• Process dental prior approval requests.
• Complete all work within all SLA requirements and timelines.
• Meet all quality and quantity benchmarks.
• Work with department leadership, Dental Director, and Dental Consultants to develop process improvements.
• Participate in workgroups that address both clinical and non-clinical internal activities.

Skills

• Knowledge of Prior Authorization and Claims.
• Establish and maintain effective working relationships with all levels of staff, other business segments, and clients.
• Self-directed with a positive attitude.
• Experience working with a virtual team with variable reporting relationships.
• Proficient with Microsoft (Word, Excel, PowerPoint, Outlook, SharePoint, & Teams), Zoom, and other web-based applications.

GDIT IS YOUR PLACE:

• Full-flex work week to own your priorities at work and at home

• 401K with company match
• Comprehensive health and wellness packages
• Internal mobility team dedicated to helping you own your career
• Professional growth opportunities including paid education and certifications
• Cutting-edge technology you can learn from
• Rest and recharge with paid vacation and holidays

The likely salary range for this position is $58,650 - $79,350. 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:

Less than 10%

Telecommuting Options:

Hybrid

Work Location:

USA NC Raleigh

Additional Work Locations:

Total Rewards at GDIT:

Our benefits package for all US-based employees includes a variety of medical plan options, some with Health Savings Accounts, dental plan options, a vision plan, and a 401(k) plan offering the ability to contribute both pre and post-tax dollars up to the IRS annual limits and receive a company match. To encourage work/life balance, GDIT offers employees full flex work weeks where possible and a variety of paid time off plans, including vacation, sick and personal time, holidays, paid parental, military, bereavement and jury duty leave. To ensure our employees are able to protect their income, other offerings such as short and long-term disability benefits, life, accidental death and dismemberment, personal accident, critical illness and business travel and accident insurance are provided or available. We regularly review our Total Rewards package to ensure our offerings are competitive and reflect what our employees have told us they value most.

We are GDIT. A global technology and professional services company that delivers consulting, technology and mission services to every major agency across the U.S. government, defense and intelligence community. Our 30,000 experts extract the power of technology to create immediate value and deliver solutions at the edge of innovation. We operate across 50 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive