Data Entry Resolutions Specialist

Data Entry Resolutions Specialist

Position: Full time

Jefferson City, MO (Hybrid).

Salary:32,000 to 34,000 per year.

Data Entry Resolutions Specialist, you will play a critical role in ensuring the accuracy and integrity of Medicaid claims processing. In this position, you will review and resolve suspended Client claims and supporting documentation by performing detailed evaluations, coordinating reviews, and accurately entering data into the electronic Medicaid Management Information System (eMMIS).

Key Responsibilities

• Review and analyze exception test pages to determine whether claims and attachments should be approved or denied in accordance with Medicaid regulations, policies, and internal guidelines.
• Stage claims and supporting documentation for medical consultant review when clinical expertise or judgment is required.
• Communicate claim determinations to healthcare providers, ensuring clear explanations and maintaining positive provider relationships.
• Utilize appropriate Explanation of Benefits (EOB) codes to document resolutions accurately within eMMIS and support payment authorization or denial decisions.
• Maintain current knowledge of Medicaid policies, system edits, regulatory requirements, and audit procedures to ensure accurate claim adjudication.
• Collaborate with cross-functional teams to improve operational efficiency and support continuous process improvement initiatives.

Required Skills and Qualifications

• Strong analytical and problem-solving abilities.
• Excellent attention to detail and accuracy in data entry.
• Ability to make informed decisions based on detailed data review and established guidelines.
• Effective verbal and written communication skills.
• Ability to work in a fast-paced, deadline-driven environment.
• Proficiency in utilizing electronic systems and databases.

Disclaimer: Diverse Lynx LLC is an Equal Opportunity Employer. All applicants and employees are evaluated without discrimination, based solely on their qualifications, ability, competence and performance. This email and its attachments may contain confidential or proprietary information and is intended only for the recipient(s). If you received this message in error, please disregard it and notify the sender. If you no longer wish to receive our communications, you may unsubscribe at any time.

Security Notice: Our official website is www.diverselynx.com We do not operate or authorize any other websites representing Diverse Lynx LLC.