Associate Insurance Representative

Good Samaritan Society; Sioux Falls, Northern (SD, KY); Hybrid; USD 21,000 - 32,000; Full time

Benefits offered by this job

Health insurance

401(k) retirement plan

Life insurance

Dental insurance

Vision insurance

Work/life balance benefits

Generous time off

Job summary

Sanford Health in Sioux Falls, SD is seeking an Associate Insurance Representative to process and monitor unpaid third party insurance accounts, including Medicare/Medicaid, and to submit claims for reimbursement. You will verify information, post payments, and assist with denials and resolutions to ensure timely, accurate billing.

The role requires a high school diploma (or equivalent) and prior billing experience is preferred.

Qualifications

• High school diploma or equivalent preferred.
• Previous billing experience preferred.

Responsibilities

• Process and monitor unpaid third party insurance accounts for proper reimbursement.
• Submit claims to payers electronically or by paper and follow up on denials.
• Ensure accounts are set up correctly and compliant with regulations.

Skills

Billing

Education

High school diploma or equivalent

Tools

Claims processing systems

Job description

Careers With Purpose

Sanford Health, the largest rural health system in the United States, is dedicated to transforming the health care experience and providing access to world-class health care in America’s heartland.

Facility: Gss National Campus
Location: Sioux Falls, SD
Address: 4800 W 57th St, Sioux Falls, SD 57108, USA
Shift: 8 Hours - Day Shifts
Job Schedule: Full time
Weekly Hours: 40.00
Salary Range: $15.00 - $23.00

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. 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.

Qualifications

High school diploma or equivalent preferred.

Previous billing experience preferred.

Benefits

Sanford offers an attractive benefits package for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 401(k) retirement plan, work/life balance benefits, and a generous time off package to maintain a healthy home-work balance. For more information about Total Rewards, visit https://sanfordcareers.com/benefits .

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 [e-mail] .

Sanford has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.

Req Number: R-0275183
Job Function: Revenue Cycle
Featured: No