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Associate Insurance Representative | PFS Billing - Long Term Care | SF

Employer
Sanford Health
Location
Sioux Falls, South Dakota
Salary
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Industry
Professional Services
Role
Other
Job Type
Long-Term

Job Details


Sanford Health is one of the largest and fastest-growing not-for-profit health systems in the United States. We're proud to offer many development and advancement opportunities to our nearly 50,000 members of the Sanford Family who are dedicated to the work of health and healing across our broad footprint.
See yourself at Sanford!

Facility: GSS National Campus

Location: Sioux Falls, SD

Shift: Day

Job Schedule: Full time

Weekly Hours: 40.00

Job Summary

The Associate Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or government-assisted program accounts for proper reimbursement; primarily but not limited to prebilled accounts.
Once six month onsite training is complete in Sioux Falls, working from home is an option. Prepares and submits claims to payers either electronically or by paper. Secures necessary medical documentation required or requested by payers. Performs account follow-up on outstanding insurance balances and takes the necessary action for account resolution in accordance with established federal and state regulations.
Processes daily workflow changes that depending on department may include, eligibility verification, verification of information, payment postings, initiating refunds, processing month end, resolving and troubleshooting incidents, reporting, initial billings and re-billings of claims, scanning and indexing of documents, and be the point of contact to provide assistance as needed. Responsible for assuring accounts are set up correctly with the information available is completed timely and accurately.
Completes work within authorized time to assure compliance with departmental standards. Keeps updated on all state/federal billing requirements and changes for insurance types within area of responsibility. Understands edits and appropriate department procedures to effectively submit and/or correct errors on claims. Processes and resolves denials that are technical in nature (i.e.: records required denials). Performs miscellaneous job related duties as requested.
Once six month onsite training is complete in Sioux Falls, working from home is an option.

Qualifications

High school diploma or high school equivalency required.
Previous billing experience preferred.
Sanford is an EEO/AA Employer M/F/Disability/Vet.
If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-877-673-0854 or send an email to talent@sanfordhealth.org .

Job Function: Revenue Cycle

Req Number: R-27487

Featured: No

Company

Sanford Health is excited to be on a journey of tremendous growth and momentum. With our vast geography, cutting-edge medicine, sophisticated research, advanced education and our own health plan, we are unique in what we do and how we do it. Through relationships built on trust and successful performance and a vision to improve the human condition, Sanford seeks to make a significant impact on health and healing. With a commitment to diversity and inclusion, our journey as an organization includes continually building on the diverse talents, experiences and beliefs of our employees, as well as the patients and communities we serve. We are proud to be from the Midwest and to impact the world. We look forward to joining with you in the journey.

Company info
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