This is a temporary position and there are no leave or retirement benefits offered with this position. Temporary employees who work an annual average of 30 or more hours per week may be eligible for health insurance coverage under the High Deductible Health Plan (HDHP). For more information on health benefits offered visit www.shpnc.org.

NOTE: If you are a current NC State Government employee, you will be considered for a temporary assignment. However, Temporary Solutionscannot accommodate dual employment.

This posting is for two full-time temporary positions located in Raleigh, NC - Wake County.

Telework Availability: We trust our employees to be self-motivated and successful in hybrid/remote roles; NC Department of Health and Human Services offers work from home options and variable work schedule flexibility for this position.

The Division of Health Benefits requires temporary workers with an approved hybrid telework schedule to work onsite at their assigned duty station at least 4 working days per month. More information on this arrangement may be obtained at the time of the interview.

Hourly Rate: $18.00 to $25.00

(Hourly Rates are based on education, experience, equity, and budget)

Position Overview: The goal of the NC Medicaid Office of Compliance and Program Integrity (OCPI) is to stop fraud, waste, and abuse in Medicaid. The Business Services Coordinator position will report to the Business Services Manager and perform a variety of operations, fiscal, and administrative functions to support the business needs of OCPI.

Job Specific Responsibilities:

• Provide timely and courteous customer service via phone, email, personally, and virtually
• Perform clerical tasks such as handling calls and correspondence, processing documentation and records
• Review and analyze claims to track trends and detect irregularities
• Conduct preliminary investigations to determine if further investigation is needed or to refer to appropriate parties
• Track and report quality data, utilize the data to identify risks, define areas of improvement and implement efficient processes
• Perform data analysis and create and maintain reports as requested by management
• Monitor, manage, and revisit workflows in the system
• Create proper documentation, workflows, and other detailed work instructions
• Assist with the design, test, and validation of any new system configurations

To receive credit for all of your work history and credentials, you must list the information on the application form. Any information listed under the text resume section or on an attachment will not be considered for qualifying credit. Qualified applicants must document on the application that they possess all of the following:

• Strong proficiency in Microsoft Office specifically Excel
• Proficient in analyzing large data files, filter data, create complex spreadsheets/reports/charts, create pivot tables, and create/edit formulas
• Proven ability to research and verify information 
• Experience preparing reports
• Ability to evaluate and analyze cases for programs requiring problem solving and critical thinking skills
• Demonstrated ability to maintain confidentiality and use good judgment in making decisions 
• Ability to establish and maintain effective working relationships
• Excellent verbal and written communication skills with strong attention to detail
• Ability to interpret and apply rules, regulations, standards, and policies 
• Ability to effectively navigate personal interactions to obtain information from a variety of individuals
• Ability to multi-task while maintaining accuracy
• Excellent problem-solving skills
• Ability to prioritize, work under pressure and meet deadlines

Management Preferences:

• Experience in Medicaid or healthcare preferred
• Experience in quality assurance, performing internal quality audits, completing appropriate documentation and/or data analysis
• Bachelor’s degree or higher in healthcare administration, business administration or relevant field

Some state job postings say you can qualify by an “equivalent combination of education and experience.” If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both. See oshr.nc.gov/experience-guide for details.

High school of General Educational Development (GED) diploma and four years of related administrative experience; or an equivalent combination of training and experience.

The North Carolina Department of Health and Human Services (NCDHHS) works closely with beneficiaries, health care professionals, community leaders and advocacy groups; local, state, and federal entities; and other community partners vested to improve the health and safety of all North Carolinians by providing essential human services. NCDHHS is one of the largest, most complex agencies in the state, with about 17,000 employees. 

The Division of Health Benefits (DHB) within NCDHHS is committed to advancing innovative solutions that improve health, promote well-being and foster independence for all North Carolinians. DHB manages and oversees North Carolina Medicaid, NC Medicaid Managed Care and other programs that provide access to services and supports for parents, children, seniors, people with intellectual / developmental disabilities, and behavioral health, substance use and traumatic brain injury disorders. With a budget over $21 billion in state and federal funds per fiscal year, DHB ensures that more than 96,000 enrolled providers are reimbursed for delivering covered services to 2.9 million beneficiaries. 

Realizing the strength of DHB lies in its employees, DHB remains dedicated in its efforts to create and maintain a diverse, equitable and inclusive workplace environment.

Pre-Employment criminal background checks are required for all positions with the Division of Health Benefits (DHB).

Due to the volume of applications received, we are unable to provide information regarding the status of your application over the phone. To check the status of your application, please log in to your account. You will either receive a call to schedule an interview or an email notifying you when the job has been filled.

For technical issues with your application, please call the NeoGov Help Line at 855-524-5627. Applicants will be communicated via email only for updates on the status of their application. If there are any questions about this posting other than your application status, please contact us at Medicaid.Recruitment@dhhs.nc.gov.