Insurance Representative

🔥 2 hours ago

🌾 Iowa, North Dakota, +3 more states – Remote

🌾 Iowa – Remote 🌾 North Dakota – Remote 🚗 Michigan – Remote ❄️ Minnesota – Remote 🗿 South Dakota – Remote

💵 $16 - $25 / hour

⏰ Full Time

🟢 Junior

🔒 Insurance

🚫👨‍🎓 No degree required

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Sanford Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1894

⚕️ Healthcare Insurance

Healthcare Insurance

Sanford Health is the largest rural health system in the United States, dedicated to transforming the healthcare experience and providing access to world-class healthcare in America's heartland. Headquartered in Sioux Falls, South Dakota, Sanford Health serves over 1. 4 million patients and nearly 200,000 health plan members across 250,000 square miles. The integrated health system includes 48 medical centers, 211 clinic locations, and more than 160 senior living centers, employing 2,900 physicians and advanced practice providers. Sanford Health is committed to offering compassionate care through its Centers of Excellence, focusing on specialties such as cancer, orthopedics, women’s health, and genetics. Additionally, it provides affordable health insurance, engages in extensive clinical trials, and supports personalized genetic medicine.

📋 Description

• The Insurance Representative processes and monitors unpaid third party insurance, Medicare, Medicaid or government-assisted program accounts for proper reimbursement. • Prepares and submits claims to payers either electronically or by paper. • Secures necessary medical documentation required or requested by payers. • Proactively identifies and performs account follow-up on outstanding insurance balances and takes the necessary action for account resolution in accordance with established federal and state regulations. • 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. • Uses advanced knowledge and understanding to process payer rejections. • Conducts trend analyses, appeals and resolves low payment or underpaid accounts. • Provides input for payer-specific meetings. • Handles difficult account situations and resolves issues delaying or preventing payments from payers. • Performs miscellaneous job related duties as requested.

🎯 Requirements

• High school diploma or equivalent preferred; post-secondary or trade courses in accounting, business, and communications would be helpful for this position. • Six months' related work experience required. • Computer skills essential.