Associate Insurance Representative - PFS Billing-Hospital

Job Title: Associate Insurance Representative | PFS Billing-Hospital | Multi-City

City: Sioux Falls

State: Multi-State

Department *: * PFS Billing-Hospital

Job Schedule: Full Time

Shift: Days

Hours Per Shift: 8 hr

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. 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. 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.

POSITION RESPONSIBILITIES

Must have excellent customer service skills to communicate with internal and external customers. Will be expected to use electronic billing. Must be accessible to other departments upon demand for inquires regarding reimbursement. Must demonstrate critical thinking skills to manage day to day basic operations or the ability to seek assistance when needed. Must be able to do work steadily, efficiently and show constant vigilance to the details of the work. Must be able to utilize all office equipment including personal computer and application software, printer, FAX, copier, multi-line telephone system. Must have good working knowledge of all insurance and/or government claims submittal and appeal processes. Must have excellent written and oral communication skills, including English usage, grammar, punctuation, and style. Must be able to use appropriate reference materials when needed. Should be able to multi-task when needed.

DEPARTMENT DETAILS

The hours for this position are Monday-Friday, between the hours of 7 a.m. to 7 p.m. There is some flexibility as to when the employee can begin their shift. This position can sit in Fargo, ND or Sioux Falls, SD. This position can sit in Fargo, ND or Sioux Falls, SD.

QUALIFICATIONS

High school diploma or high school equivalency required. Previous billing experience preferred.

About Sanford Health:

At Sanford Health, we are dedicated to the work of health and healing.
Every day, we show that commitment by delivering the highest quality of care to the communities we serve.
We are leaders in health care and strive to provide patients across the region with convenient access to expert medical care, leading-edge technologies and world-class facilities.
In addition to strong clinical care, we are also committed to research, education and community growth.
We engage in medical research to not only discover innovative ways to provide care, but also cures for common diseases.
We continuously seek new ways to achieve our vision of improving the human condition here in your community,
across the region and around the world.
The entire team at Sanford Health recognizes the value of healthy families and communities.
We continue to gain momentum and expand our reach. Together, we can make a positive difference now, and in the future.
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 .
In compliance with federal law requiring employers to verify new employees' U.S.
employment eligibility, Sanford participates in E-Verify. To learn more click here for English Version at https://e-verify.uscis.gov/emp/media/resourcesContents/EverifyPosterEnglish.pdf or here for Spanish Version at https://e-verify.uscis.gov/emp/media/resourcesContents/EverifyPosterSpanish.pdf .

City: Sioux Falls

State: Multi-State

Job Function: Revenue Cycle

Job Schedule: Full Time

Shift: Days

Req Number: req24829