Healthcare Claims Examiner - Dental Hygienist

General Dynamics
United States
Workplace: HybridFull timeUSD 62,050 - 83,950 annuallyFunction: Healthcare (Clinical, Medical, Wellness)Experience: 5+ yearsSkills: ["Independent thinking","Claims processing","Compliance focus","Computer literacy"]

Review and process dental prior approval requests for North Carolina Medicaid using the NCMMIS claims processing system. Ensure requests meet organizational and government requirements and support compliance with Medicaid policy. Work independently to meet service level agreements and performance standards, using Windows-based applications, NCTracks, and Microsoft Office tools (Word, Excel, OneNote, Outlook) to analyze, document, and communicate decisions.

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FursaFursa
General Dynamics
General Dynamics
3 days ago

Healthcare Claims Examiner - Dental Hygienist

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Source: Company careers pageValidated by: Fursa AI
Last checked: 11 hours agoStatus: Live

Job Summary

Review and process dental prior approval requests for North Carolina Medicaid using the NCMMIS claims processing system. Ensure requests meet organizational and government requirements and support compliance with Medicaid policy. Work independently to meet service level agreements and performance standards, using Windows-based applications, NCTracks, and Microsoft Office tools (Word, Excel, OneNote, Outlook) to analyze, document, and communicate decisions.
Location: United States
Workplace: Hybrid
Employment Type: Full time
Job Function: Healthcare (Clinical, Medical, Wellness)
Seniority: Mid level

Key Responsibilities

  • •Analyze dental prior approval requests for North Carolina Medicaid to ensure compliance with organizational and government guidelines.
  • •Process and review dental prior approval requests within the NCMMIS claims processing system.
  • •Maintain accuracy and thoroughness using Medicaid policy knowledge and program guidelines.
  • •Work independently to meet service level agreements and individual performance standards.
  • •Use Microsoft Office and Windows-based tools (including Outlook and NCTracks) to support review and documentation.

Pay and Benefits

Salary: USD 62,050 - 83,950 annually
Perks:Health InsuranceDentalVision Plan401kPaid LeavePaid HolidaysPaid ParentalLife InsuranceHsa

Key Requirements

  • •Active North Carolina license as a Registered Dental Hygienist (RDH).
  • •5+ years of clinical dental hygiene experience.
  • •Ability to work independently to meet service level agreements and performance standards.
  • •Proficiency with Microsoft Office (Word, Excel, OneNote) and Microsoft Outlook.
  • •Experience using Windows-based computer applications and NCTracks with thorough Medicaid policy knowledge.
Experience:5+ years
Skills:Independent thinkingClaims processingCompliance focusComputer literacy
Licenses:Registered Dental Hygienist (RDH)North Carolina license
Tech Stack:NCMMISNorth Carolina Department of Health and Human Services (NC DHHS)NCTracksMedicaidMicrosoft OfficeMicrosoft WordMicrosoft ExcelMicrosoft OneNoteMicrosoft OutlookWindowsComputer applicationsDigital tools

Company Brief

General Dynamics
Provides IT, systems engineering, cybersecurity, cloud, and mission support services to U.S. federal civilian and defense agencies, delivering large-scale technology solutions and managed services for national security and government operations.
Industry: Defense Technology
Company Size: Enterprise (1,001+ employees)
Growth: Established Company
Headquarters: Tysons / Fairfax, United States
WebsiteLinkedIn