Data Entry Resolutions, Jefferson City

Data Entry Resolutions Specialist

As a Data Entry Resolutions Specialist at Infocrossing INC, you will play an essential role in maintaining the accuracy and integrity of Medicaid claims processing. Your primary responsibility will be to resolve suspended MO HealthNet claims and their associated attachments through detailed evaluation, staging for review, and precise data entry within our electronic Medicaid Management Information System (eMMIS). Your daily duties will include:Thoroughly analyzing exception test pages to accurately determine if claims and attachments should be approved or rejected, ensuring compliance with relevant regulations and internal standards. Coordinating with medical consultants by staging claims and attachments that require clinical judgment, facilitating an efficient review process.Communicating clearly with healthcare providers to explain determinations regarding their claims, fostering transparency and improving provider relations. Utilizing EOB (Explanation of Benefits) codes to document resolutions accurately within the eMMIS platform for payment authorization or claims denial.Keeping pace with updates in Medicaid policies, system edits, and audit processes to maintain relevance and accuracy in claim resolution. This position requires an individual with strong analytical skills, diligent attention to detail, and the capacity to make well-informed decisions based on systematic data review. You will collaborate closely with cross-functional teams to enhance the claim processing cycle, thereby contributing directly to the operational excellence of BPS-IHS. We emphasize continuous learning and provide opportunities to develop within a fast-evolving healthcare administration environment, positioning you to broaden your expertise in Medicaid claim adjudication.Core competencies include: Client Centricity: Demonstrate a strong commitment to understanding and addressing the needs of healthcare providers and stakeholders. Passion for Results: Maintain enthusiasm and dedication toward achieving accurate, timely, and compliant claim resolutions. Execution Excellence: Ensure all assigned tasks meet quality standards through disciplined work habits and adherence to procedural guidelines.Collaborative Working: Engage proactively with medical consultants, providers, and team members to foster a supportive and transparent work environment. Learning Agility: Embrace continuous improvement by adapting quickly to changes in Medicaid regulations, system updates, and process enhancements.Problem Solving&Decision Making: Apply critical thinking to evaluate complex claims data and make informed determinations. Effective Communication: Convey findings and resolutions clearly and professionally, whether in writing or verbal interactions with providers and colleagues. About Infocrossing INC and Business Process Services - BPS-IHS: Infocrossing INC operates under the Business Process Services (BPS) strategy line, specifically within the BPS-IHS EH Group. We are dedicated to delivering innovative, end-to-end digital transformation solutions that empower healthcare entities to optimize their operational efficiency. Our team operates in a dynamic environment where accuracy, compliance, and customer service are paramount. The BPS-IHS EH group focuses on Medicaid and healthcare claims services, enabling enhanced data management and claims adjudication that supports healthcare providers and payers in achieving timely reimbursements.Why Join Us? At Infocrossing INC, we are reinventing the future of digital healthcare services. Joining our team means becoming part of a forward-thinking company committed to transforming the Medicaid claims processing landscape. We believe that our people are our greatest asset, and we support their growth by providing an empowering work environment, ongoing learning opportunities, and the chance to make a meaningful impact. Our culture encourages reinventionnot just of our processes but of personal careers. We recognize that dynamic change requires adaptability and innovative thinking, and we want passionate individuals who are eager to be part of that evolution. We embrace diversity and inclusivity in our hiring practices. Applications from people with disabilities and those from diverse backgrounds are encouraged and explicitly welcome, as we strive to create a workplace where everyone has equal opportunity to thrive.The expected compensation for this role ranges from $32,000 to $34,000 annually. Final compensation will depend on various factors, including your geographical location, minimum wage obligations, skills, and relevant experience. Based on the position, the role is also eligible for Wipro's standard benefits including a full range of medical and dental benefits options, disability insurance, paid time off (inclusive of sick leave), other paid and unpaid leave options.