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Sanford Health Associate Insurance Representative - PFS - Revenue Cycle in Sioux Falls, South Dakota

Job Title: Associate Insurance Representative | PFS - Revenue Cycle | Sioux Falls

City: Sioux Falls

State: SD

Department : PFS - Revenue Cycle

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.

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.

POSITION RESPONSIBILITIES

Completes assigned tasks, seeking help when needed. Reports variances and makes agreed-upon corrections. Provides direct service to internal or external customers. Completes current work according to assigned priorities. Verify accuracy of billing data and revise any errors.

DEPARTMENT DETAILS

The hours for this position are flexible between 5:00 a.m. and 7:00 p.m. Monday through Friday. This position will 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.

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 .

City: Sioux Falls

State: SD

Job Function: Revenue Cycle

Job Schedule: Full Time

Shift: Days

Req Number: WD13384

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