Patient Account Specialist

Avera; Sioux Falls (SD); Hybrid; USD 26,000 - 36,000; Full time

Benefits offered by this job

PTO from day 1

Employer retirement matching (up to 5%

Career development and mentorship

Job summary

Avera Downtown Building-Sioux Falls is seeking a healthcare accounts receivable specialist to manage patient account follow-ups and collaborate with insurance payers to resolve issues.

The role involves reviewing unpaid, overpaid, and denied claims, contacting payers, and supporting patient responsibility follow-up. A hybrid schedule is available after the initial onsite period, with emphasis on confidentiality and teamwork.

Qualifications

• Associate's or technical degree required.
• 1-3 years of related experience preferred.
• Ability to communicate effectively, maintain confidentiality, and work in a team.

Responsibilities

• Follow up on accounts receivable by contacting insurance companies.
• Review and follow up on unpaid, overpaid, and denied claims.
• Review and appeal denials related to claims processing.
• Communicate with internal and external customers to resolve claims.
• Assist with patient responsibility follow-up and on-site facility support.

Skills

Accounts receivable

Insurance follow-up

Team communication

Education

Associate's or technical degree

Job description

Hybrid

Sioux Falls, SD

Full time

R-260028485

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

Opportunity to work a hybrid schedule after 3-6 months onsite.

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].

At Avera, the way you are treated as an employee translates into the compassionate care you deliver to patients and team members. Because we consider health care a ministry, you can live out your faith, uphold the dignity and respect of all persons while not compromising high-quality services. Join us in making a positive impact on moving health forward.

The policy of Avera to provide opportunities for all qualified employees or applicants without regard to disability and to provide reasonable accommodations for all employees or applicants who may be disabled. Avera is committed to ensuring compliance in accordance with the Americans with Disability Act. For assistance, please contact HR Now at 605-504-4444.

Additional Notices:

For TTY, dial 711

Avera is an Equal Opportunity/Affirmative Action Employer: Minority/Female/Disabled/Veteran/Sexual Orientation/Gender Identity.