Insurance Specialist - Business Office

Prairie Lakes Healthcare System
Full Time
Watertown, SD 57201
Posted
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Job description
Job Code:
Insurance Specialist - Business Office - Full Time


Department:
Business Office

Shift:
Day Shift

Job Type:
Full Time (1.0)

Job Description:


POSITION: Insurance Claims Clerk

STATUS: Full-Time/1.0

POSITION SUMMARY: Performs the submission and follow-up of insurance claims for all service lines. Ensures billing procedures are followed to maximize cash and minimize accounts receivable.

RESPONSIBILITIES: Completes all edits to ensure claim submissions are compliant with federal and state regulations. Performs follow-up on insurance claims to obtain maximum payment promptly. Administers timely and accurate billing and payment of all service lines
Processes all secondary claims to seek reimbursement following primary insurance payment. Researches and resolves requests from insurance companies, patients, and third-party payors. Resolves billing problems and assists interdepartmentally with billing issues. Assists co-workers with problem resolution and team projects to decrease accounts receivable. Works with patient account specialists on private pay accounts. Assists patients with insurance-related questions and problems.
Completes monthly billing of reoccurring accounts ((i.e. kidney dialysis, radiation, chemotherapy, home health, hospice, and physician). Other duties may be assigned.
Education and/or Experience: High school diploma or general education degree (GED); or equivalent combination of education and experience. One year prior medical or general office experience is preferred. Previous billing and computer experience desirable.
Our excellent benefits package includes: Health, Dental, Life, Short-Term Disability, and Vision insurance options, 403b with employer contribution, Paid holidays, generous paid time off accrual, professional development program with many opportunities for growth and advancement.

CONTACT: employment@prairielakes.com

EEO/AA



Minimum Qualifications:


CMS requires that health care staff be Covid-19 vaccinated or Religious and Medical Exemptions will be required.

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