Dental Prior Approval Reviewer

Dental Prior Approval Reviewer

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.

Work Requirements

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Years of Experience
5 + years of related experience

* may vary based on technical training, certification(s), or degree

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Certification

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Travel Required
None

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Citizenship
U.S. Citizenship Required

About Our Work

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.

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.