Dental Prior Approval Reviewer Job at GDIT, Raleigh, NC

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  • GDIT
  • Raleigh, NC

Job Description

Responsibilities for this Position

Location: USA NC Raleigh - 2610 Wycliff Rd (NCS010)
Full Part/Time: Full time
Job Req: RQ184259

Type of Requisition:
Regular

Clearance Level Must Currently Possess:
None

Clearance Level Must Be Able to Obtain:
None

Suitability:

Public Trust/Other Required:
None

Job Family:
Healthcare Claims

Job Qualifications:

Skills:
Data Entry, Dental Care, Microsoft Office, Microsoft Outlook
Certifications:

Experience:
5 + years of related experience
US Citizenship Required:
Yes

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 NCMMIS call center supports this system by handling inbound calls from hospitals and physicians concerning claims and enrollment inquiries.

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 government guidelines.

Minimum Requirements:

Requires active North Carolina license as a Registered Dental Hygienist.

5+ years of clinical dental hygiene experience.

The ideal candidate will have:

Ability to work independently to meet service level agreements within the contract and individual performance standards.

Proficiency with Microsoft Office suite of applications.

Proficiency with Microsoft Outlook email.

Experience and good comfort level using Windows based computer applications.

Experience using NCTracks is a plus.

Knowledge of business processes of NC DHHS is a plus.

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:
None

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 30 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology.

We connect people with the most impactful client missions, creating an unparalleled work experience that allows them to see their impact every day. We create opportunities for our people to lead and learn simultaneously. From securing our nation's most sensitive systems, to enabling digital transformation and cloud adoption, our people are the ones who make change real.

GDIT is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other protected class.





PI248280957




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 NCMMIS call center supports this system by handling inbound calls from hospitals and physicians concerning claims and enrollment inquiries.


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 government guidelines.


Minimum Requirements:


Requires active North Carolina license as a Registered Dental Hygienist.


5+ years of clinical dental hygiene experience.


The ideal candidate will have:


Ability to work independently to meet service level agreements within the contract and individual performance standards.


Proficiency with Microsoft Office suite of applications.


Proficiency with Microsoft Outlook email.


Experience and good comfort level using Windows based computer applications.


Experience using NCTracks is a plus.


Knowledge of business processes of NC DHHS is a plus.


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:
None



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 30 countries worldwide, offering leading capabilities in digital modernization, AI/ML, Cloud, Cyber and application development. Together with our clients, we strive to create a safer, smarter world by harnessing the power of deep expertise and advanced technology.


We connect people with the most impactful client missions, creating an unparalleled work experience that allows them to see their impact every day. We create opportunities for our people to lead and learn simultaneously. From securing our nation's most sensitive systems, to enabling digital transformation and cloud adoption, our people are the ones who make change real.


GDIT is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status, or any other protected class.











PI248280957

Job Tags

Holiday work, Full time, Contract work, Temporary work, Part time, Work experience placement, Immediate start, Remote job, Worldwide, Flexible hours,

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