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Sanford Health Accounts Receivable Representative | PFS Billing - Long Term Care in Sioux Falls, South Dakota

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.

#crosspost 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.

Department Details

This position will verify pay source for Home Health and Hospice, scan, index and set up and discharge Lifeline accounts. The hours for this position are flexible between 7:00 a.m. and 6:00 p.m. Monday - Friday.

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-17439
Featured: Yes

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