Claims and Encounter Technical Analyst

State of North Carolina

7d • Hybrid

About The Position

The position will serve as a technology liaison for the Managed Care Business Operations team in order to assist with the resolution of Medicaid direct and encounter claims. The position should understand business processes, Medicaid processes, and technical expertise with Medicaid direct claims and encounters. The position is expected to work with technical staff with GDIT and other internal teams to resolve claims and encounters. This position will be responsible for planning, organizing, requirements definition, change service request (CSR) generation. defect identification and management, training and testing.

Requirements

• Bachelor’s degree from appropriately accredited institution in a discipline related to the area of assignment with three years of programmatic experience related to the area of assignment; or an equivalent combination of training and experience.

Nice To Haves

• Knowledge of federal managed care requirements and the ability to ensure program and operational compliance across claims and encounter processes.
• Skill in identifying, analyzing, and resolving business and technology issues that affect accurate claim and encounter data submission.
• Experience providing oversight of the Encounter Processing System for Managed Care, including monitoring performance and addressing system‑related issues.
• Ability to evaluate and troubleshoot encounter and claims data challenges, using findings to recommend improvements to business processes and supporting systems.
• Proficiency in planning, coordinating, and analyzing activities related to claims and encounter processing, including data validation to ensure accuracy, efficiency, and effective workflow.

Responsibilities

• Planning
• Organizing
• Requirements definition
• Change service request (CSR) generation
• Defect identification and management
• Training
• Testing

Benefits

• Employees can participate in health insurance options, standard and supplemental retirement plans, and the NCFlex program (numerous high-quality, low-cost benefits on a pre-tax basis).
• Employees also receive paid vacation, sick, and community service leave.
• In addition, paid parental leave is available to eligible employees.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Number of Employees: 1,001-5,000 employees