Healthcare Claims Assistant III

General Dynamics Information Technology have created the premier provider of high-tech IT solutions to the government IT market. Together as General Dynamics Information Technology, we deliver cost-effective, next-generation IT solutions and services to the Department of Defense, the intelligence community and federal civilian agencies as they modernize their information systems.

GDIT is currently seeking a Provider Enrollment Specialist III to support provider credentialing initiatives and ensure compliance with federal and state regulations. In this role, you will be instrumental in preparing provider packets for review by the credentialing committee while maintaining confidentiality and ensuring the removal of all Personally Identifiable Information (PII). You will serve as a key liaison in supporting application processing, enrollment denials, and provider terminations.

RESPONSIBILITIES:

• Redact credentialing documentation including background checks, license verification, disciplinary actions, and other provider-sensitive information prior to committee review.

• Create and format credentialing packets for the Credentialing Committee, ensuring accuracy and completeness while removing all PII.

• Collaborate with internal and external sources to confirm provider licensure and compliance with NC Medicaid enrollment requirements.

• Serve as support for enrollment denials and termination workflows, assisting in resolution and communication with stakeholders.

• Maintain a high standard of quality and attention to detail in all provider documentation and credentialing tasks.

• Assist in background compliance reviews leveraging tools like Lexis Nexis and other verification systems.

• Meet daily quantity and quality standards as defined by operational performance targets.

QUALIFICATIONS:

Requires Skills and Experience - 

• Minimum 2 years of credentialing & administrative experience in a healthcare setting

• Strong understanding of NC Medicaid or other healthcare programs
• Familiarity with NCTracks and provider enrollment guidelines

• Proficiency with Microsoft Office Suite including Word, Excel, and Outlook

• Exceptional attention to detail and organization skills

Desired Skills and Experience:

• Direct experience with credentialing processes

• Knowledge of Lexis Nexis or similar background verification platforms

• Background in customer service or provider relations

• Experience using digital fax systems, healthcare software, and telecommunications technology

ATTRIBUTES FOR SUCCESS:

• Strong analytical and written communication skills

• Ability to follow complex instructions and document processing standards

• A high sense of accountability and confidentiality
• Detail-oriented with the ability to audit documentation and catch discrepancies