Top 26 Insurance verification Jobs in Sioux Falls, Sd

Insurance Specialist | PRN
Avera —Sioux Falls, SD
- $19.50 - $25.50 an hour
- Part-time
- OSHA
- Hospital
- HIPAA
8d
Senior Secretary
South Dakota State Government —Sioux Falls, SD
- $20.47 an hour
- Online Application
- Microsoft Excel
- Microsoft Outlook
- English
- Paid holidays
- Health insurance
9d
Medical Receptionist
VRA Vision —Sioux Falls, SD
- $19 - $21 an hour
- Full-time
- Hybrid work
- Clinic
- Outpatient
- Entry level
- Health insurance
- Dental insurance
Quick Apply
9d
Admissions Specialist
Avera —Sioux Falls, SD
- $18.00 - $23.25 an hour
- Weekends as needed
- OSHA
- Hospital
- HIPAA
- Paid time off
6d
Associate Credentialing Specialist
Sanford Health —Sioux Falls, SD
- $17.50 - $28.00 an hour
- 8 hour shift
- Background check
- Pass drug screening
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Patient Services Representative - Neurology
Avera —Sioux Falls, SD
- $18.00 - $23.25 an hour
- Online Application
- OSHA
- High school diploma or GED
- Clinic
- Paid time off
2d
Admissions Specialist I - weekend shift
Avera —Sioux Falls, SD
- $18.00 - $23.25 an hour
- Part-time
- OSHA
- Hospital
- HIPAA
2d
Lead Patient Access Representative | Family Medicine | 40 hours/week
Sanford Health —Sioux Falls, SD
- $18.50 - $29.00 an hour
- Online Application
- Background check
- Pass drug screening
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
Senior Administative Assistant
Sanford Health —Sioux Falls, SD
- $19 - $28 an hour
- 8 hour shift
- Background check
- Pass drug screening
- Office
- Health insurance
- Dental insurance
Quick Apply
Biller II
TURNWELL MENTAL HEALTH NETWORK INC —Sioux Falls, SD
- HIPAA
- Research
- Mid-level
Quick Apply
Medical Scheduler - PRN - Avera Cancer Institute
Avera —Sioux Falls, SD
- $18.00 - $23.25 an hour
- Part-time
- OSHA
- High school diploma or GED
- Clinic
Dental Receptionist
Sabal Smiles —Sioux Falls, SD
- Full-time
- Dental office
- Leadership
- Communication skills
Quick Apply
Customer Experience Specialist
Schulte Subaru —Sioux Falls, SD
- $17 - $20 an hour
- Full-time
- Background check
- Dealership
- Writing skills
- Paid holidays
- Disability insurance
Quick Apply
Patient Access Representative | Acute Care | PRN
Sanford Health —Sioux Falls, SD
- $16.25 - $23.00 an hour
- Online Application
- Acute care
- Background check
- Hospital
Quick Apply
11d
Sr. Account Service Representative
Wellmark, Inc. —Sioux Falls, SD
- Full-time
- Hybrid work
- Microsoft Excel
- Microsoft Outlook
- Research
Quick Apply
Patient Services Specialist I
TURNWELL MENTAL HEALTH NETWORK INC —Sioux Falls, SD
- Full-time
- Bilingual
- HIPAA
- Administrative experience
Quick Apply
9d
CIBMTR Program Manager
Registry Partners —United States
- From $35 an hour
- Weekends as needed
- Remote
- 5 years
- Supervising experience
- Senior level
- Health insurance
- Dental insurance
Quick Apply
Surgical Program Manager Adult NSQIP
Registry Partners —United States
- Weekends as needed
- Remote
- Nursing
- Surgery
- Mid-level
- Health insurance
- Dental insurance
Quick Apply
9d

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Insurance Specialist | PRN

Avera -
Sioux Falls, SD

Apply Now

Job Details

Part-time
$19.50 - $25.50 an hour
8 days ago

Qualifications

TJC
In-person patient registration
Health insurance co-pays
Overseeing health insurance pre-certification
OSHA
Managed care
CMS
Regulatory compliance
Patient demographics
HIPAA
Associate's degree in finance
Mid-level
Patient financial aid assistance
Finance
Medicaid health insurance
Clinical data entry
Clinical information systems
Health information regulatory compliance
Emergency Medical Treatment and Labor Act (EMTALA)
Medicaid regulations
Medicaid
Health insurance referral requirements
1 year
Clinical confidentiality policies
Medical billing regulations compliance
Patient collections management

Full Job Description

Location:

Avera Health

Worker Type:

PRN

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

Responsible for ensuring insurance eligibility, benefit verification, and the authorization processes are complete in the time allowed by the insurance companies to prevent denials or penalties. Specialists are responsible for documenting accurate insurance information and authorization details to optimize reimbursement from both the payer and patient. The Specialist must maintain strong working knowledge of insurance plans, contract requirements, and resources to facilitate appropriate insurance verification and authorization. Specialists must also be able to understand and interpret patient liability and benefits for all payer types including copays, co-insurance, and out-of-pocket responsibilities in order to provide patients and families with information on their financial responsibility. The Specialist will calculate and communicate to the patient a financial responsibility estimation, provide charity applications and/or direct the patient to the business office for payment and assistance options. The Specialists will collect patient liability prior to service and attempt to collect prior balances. The Specialist collaborates with various other departments to ensure proper reimbursement on accounts. The Specialists are to conduct all transactions appropriately and consistently, and complete government regulatory forms accurately with the patient or patient's representative. Specialists must maintain compliance with government regulations (i.e. EMTALA and HIPAA) as it pertains to the insurance process.

What you will do

Process eligibility and secure full benefit coverage information (including COBRA when applicable) with insurance companies and employers, confirm all demographic information is correct, and ensure coordination of benefit (COB) and insurance plan codes are accurate. Specialists must verify insurance coverage immediately for inpatient and outpatient accounts that are same day and next day add-ons.
Identify all payment sources for accurate primary and secondary payer coverage and required authorizations to prevent denials and/or reduction in payment for patients entering the facility for care.
Obtain necessary paper/electronic referrals, authorizations and pre-certifications from Primary Care Physician and/or Specialty Physician when required by payers, Managed Care, and traditional Medicaid and enters information into the health information system.
Collects and validates accurate patient demographic and insurance information, verifies insurance, obtains pre-certification/authorization as required and enters all necessary information.
Calculate and communicate patient estimates for hospital services utilizing a deposit matrix or patient payment estimator to determine estimated patient responsibility and communicates financial expectations to the patient.
Educates patients on their benefits, offers the patient/family the opportunity to pay their estimated patient responsibility prior to services rendered, and identifies methods of payment available. Identifies patients in need of financial assistance and provides charity applications and referrals to the business office as necessary.
Responsible to screen all self pay patients for potential payer coverage and directs applicable accounts to the advocacy team for further review. Assure all payer requirements are met, including non-coverage waivers, Advance Beneficiary Notices, sterilization forms, and other forms as applicable.
Provide communication concerning change of insurance coverage, prior to billing, from Registration staff and/or Patient Advocate/Billing staff.
Maintain professional development by attending workshops, in-services, and webinars to remain up-to-date on insurance rules and regulations in addition to changes within the industry.

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.

Required Education, License/Certification, or Work Experience:

1-3 years Related experience in billing, insurance or registration.
1-3 years Healthcare experience

Preferred Education, License/Certification, or Work Experience:

Associate's finance, business or healthcare.

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.

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 [email protected] .

Apply Now

Refine Your Search

insurance verification jobs in sioux falls, sd

Insurance Specialist | PRN

Senior Secretary

Medical Receptionist

Admissions Specialist

Associate Credentialing Specialist

Patient Services Representative - Neurology

Admissions Specialist I - weekend shift

Lead Patient Access Representative | Family Medicine | 40 hours/week

Senior Administative Assistant

Biller II

Medical Scheduler - PRN - Avera Cancer Institute

Dental Receptionist

Customer Experience Specialist

Patient Access Representative | Acute Care | PRN

Sr. Account Service Representative

Patient Services Specialist I

CIBMTR Program Manager

Surgical Program Manager Adult NSQIP

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