Data Entry, Processing, Review & Verification and Associated Tasks
- Scope of Work
DSS is seeking a qualified individual to augment staff for data entry, processing, review and verification and associated tasks. Activities include but are not limited to:
- Data entry.
- Reviewing records and documentation.
- Utilizing various systems for processing, reviewing, and verifying data such as mainframe, Datacap, Provider Enrollment Portal, and File Director.
- Knowledge of claims documents including CMS-1500 and UB-04 CMS-1450.
- Verifying data against various sources both manually and through technology for claim verification.
- Indexing claims.
- Application of policies and procedures for data entry, processing, review, and verification.
- Provider or stakeholder outreach.
- Monitoring completion of activities by established deadlines.
- Conducting quality control of work to show adherence expectations.
- Other administrative and data entry tasks as assigned.
- Project Location:
The successful candidate will be located with access to provide this consultant work to the State of South Dakota which may include some onsite/virtual collaboration.
- Work Order Duration:
The duration of this work order is expected to last 36 months commencing on or about June 1, 2026, and ending May 31, 2029. A signed contract for RFP19317 is required for this work.
This amendment may be terminated by either party hereto upon thirty (30) days written notice. Upon termination of this amendment, all accounts and payments shall be processed for services rendered to date of termination.
- Work Order Response:
Responses to this work order must include resumes and references for each qualified candidate and should demonstrate and give examples of the following:
- Track history performing services directly to DSS in the activities outline in the scope provided.
- Thorough familiarity utilizing Datacap, Provider Enrollment Portal, and File Director, and knowledge of claims.
- Understanding of the policy and procedures, processes and protocols in verifying data, expectations for completion of activities and in conducting quality control functions.
- Experienced employee with thorough knowledge of the provider enrollment and outreach process including stakeholder contact and outreach.
- Ability to expand or contract services as necessary to meet DSS’ needs as demonstrated through past performance.
- Office and staff presence in Pierre, SD as well as security and HIPAA compliant office in Rapid City, SD capable of supporting the work order.
Work order responses should outline:
- Understanding of the work to be performed.
- Resume, references, and qualifications for each proposed candidate.
- Confirmation of availability based on work order request.