Patient Account Specialist

Sioux Center Health; Sioux Falls (SD); On-site; USD 2,686,000 - 3,513,000; Full time

Benefits offered by this job

PTO available day 1 for eligible hires

Up to 5% employer matching retirement

Career development mentorship

Job summary

Avera Downtown Building-Sioux Falls is seeking an Accounts Receivable Specialist to manage the Avera Medical Group patient accounts. You will perform follow-up with insurance companies and coordinate with internal teams to resolve account issues, ensuring timely claims processing and accurate rebilling when needed.

This role requires an associate's or technical degree and 1–3 years of related experience, strong attention to detail, and effective communication.

Qualifications

• Associate's or technical degree required.
• 1–3 years of related experience.
• Ability to communicate effectively and maintain confidentiality.

Responsibilities

• Follow-up on accounts receivable by contacting insurance companies.
• Review unpaid/denied claims and assist with rebilling as needed.
• Analyze denials and appeals related to claims processing with payers.
• Communicate with internal and external customers to ensure timely claims processing.

Education

Associate's or technical degree

Job description

Pay Range
The pay range for this position is listed below. Actual pay rate dependent upon experience.

Location:
Avera Downtown Building-Sioux Falls
Worker Type
Regular
Work Shift
Day Shift (United States of America)
Pay Range
The pay range for this position is listed below. Actual pay rate dependent upon experience.
$19.50 - $25.50
Position Highlights
You Belong at Avera
Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.
A Brief Overview
Accountable for having a high level of knowledge of the Avera Medical Group patient accounts responsibilities for the Avera Medical Group Clinics. They are responsible for complete follow-up of patient accounts, working closely with insurance companies and internal team members to resolve account issues.

What You Will Do

• Responsible for follow-up on accounts receivable by contacting insurance companies.
• Closely follows the appropriate procedures and practices.
• Responsible for account review and follow up of unpaid, overpaid/over adjusted and denied claims.
• Reviews, analyzes, and appeals denials received relative to claims processing issues with insurance payers.
• Communicates with internal and external customers involved in the claims resolution process to ensure timely claims processing.) Identifies the need to rebill claims through account review and completes claim refiling as well as submits secondary claims not auto- generated through the system.
• Assist with patient responsibility follow-up as needed.
• Responsible for being available to answer direct patient inquiries.
• Support any on site facility needs as determined by leadership.
  

Essential Qualifications

The individual must be able to work the hours specified. To perform this job successfully, an individual must be able to perform each essential job function satisfactorily including having visual acuity adequate to perform position duties and the ability to communicate effectively with others, hear, understand and distinguish speech and other sounds. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer.

Preferred Education, License/Certification, Or Work Experience

• Associate's or technical degree.
• 1-3 years of related experience.
  

Expectations and Standards

• Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community.
• Promote Avera’s values of compassion, hospitality, and stewardship.
• Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity.
• Maintain confidentiality.
• Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment.
• Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable.
  

Benefits You Need & Then Some
Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future.

• PTO available day 1 for eligible hires.
• Up to 5% employer matching contribution for retirement
• Career development guided by hands-on training and mentorship
  

Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to [e-mail].