Insurance Specialist – Full-time

Join the team at Avera!

Award Winning Health Care: Avera has been named among the nation’s 15 Top Health Systems, Forbes list of America’s Best-in-State Employers and Level 10 Most Wired Health Care Organization by CHIME.

Culture: Be part of a multidisciplinary team built on teamwork, with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter.

You Belong at Avera: Competitive pay, front-loaded PTO and options for free health insurance, sign-on bonuses, various shifts to fit your lifestyle and opportunities for career growth.

Exciting opportunity to join Avera as an Insurance Specialist!

Position Highlights:

Paid Time Off (PTO) available on Day 1!

Options for Free Health Insurance!

Positive Work Environment: Be part of an organization where we practice the mission in our daily operations.

Career Growth opportunities with the largest employer in South Dakota.

Job Summary

PreArrival Management Specialist is 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.

Financial Clearance Specialists must determine if pre-certification, pre-authorization or a referral is required for insurance companies and obtain if applicable.

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 PreArrival Management Specialist will calculate and communicates to the patient a financial responsibility estimation, provide charity applications and/or direct the patient to the buisness office for payment and assistance options.

Specialists will collect patient liability prior to service and attempt to collect prior balances.

The Specialist also collaborates with the Utilization Review, Business Offce and the Patient Advocates to ensure proper reimbursement on accounts.

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.

Education and/or Experience

High school diploma or general education degree required.

Associate’s Degree in finance, business or healthcare preferred.

One to two years related experience in billing, insurance or registration required.

Healthcare experience required.

Work Schedule

Monday-Friday, 8:00am-4:30pm; 80hrs/2wks

Pay

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$18.25 – $23.00 per hour

What Makes Avera Special? (http://www.avera.org/careers/what-makes-avera-special/)

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.