Administrative Specialist/Appeals Administrative Specialist

State of North Carolina•Wake County, NC

About The Position

The Administrative Specialist I provides administrative support to the Due Process operations and Appeals Team within the Division of Health Benefits. The role supports provider reconsiderations, expedited hearing requests, and Medicaid Direct and Managed Care appeals. It maintains documentation of activities, reports, correspondence, policies, and communication files, and supports telephone inquiries, expedited appeal requests, statistical reports, contract management, provider reconsideration requests, and internal operations. Administrative support tasks include responding to telephone calls, messages, and emails; collecting and distributing mail; drafting beneficiary and vendor correspondence; preparing calendar meetings and attachments; filing, copying, and scanning; formatting reports; and performing other activities as directed. The position requires the ability to lift 20 pounds.

Requirements

High school diploma or GED and two years of related administrative experience, or an equivalent combination of education and experience.
Able to lift 20 pounds.

Nice To Haves

Experience with customer outreach.
Experience creating data reports.
Experience with contract management.
Experience with billing or payment of medical claims.

Responsibilities

Provide administrative support to Due Process operations and the Appeals Team.
Support provider reconsiderations, expedited hearing requests, and Medicaid Direct and Managed Care appeals.
Maintain documentation of activities, reports, correspondence, policies, and communication files.
Handle telephone inquiries, expedited appeal requests, statistical reports, contract management, provider reconsideration requests, and internal operations.
Answer and respond to telephone calls, messages, and emails.
Collect and distribute mail.
Draft beneficiary and vendor correspondence.
Prepare calendar meetings and applicable attachments.
File, copy, scan, and format reports.
Perform other activities as directed.