- Sedgwick (Pierre, SD)
- …equivalent combination of education and experience required to include two (2) years claims supervisor experience. **Skills & Knowledge** + Thorough knowledge of ... Lead **PRIMARY PURPOSE** : To act as an intermediary between clients and auto claims team; handle and track any escalations appropriately, lead and educate in client… more
- HomeSafe Alliance (Sioux Falls, SD)
- **Title:** Assistant Claims Manager (Military Move) **HomeSafe Alliance** is the single global household goods movement manager of over 300,000 Military Household ... motivated **Assistant** **Cl** **aims Manager** to assist in all aspects of claims management, to support and promote process improvement methodologies and best… more
- Sedgwick (Pierre, SD)
- …Place to Work(R) Most Loved Workplace(R) Forbes Best-in-State Employer Surety Claims Specialist **PRIMARY PURPOSE** **:** To analyze complex or technically difficult ... surety and surety bond claims ; to provide resolution of highly complex nature and/or...coding is correct. + Refers cases as appropriate to supervisor and management. + Delegates work and mentors assigned… more
- Sedgwick (Pierre, SD)
- …mainly Australia. If this does not apply to you please use the 'Apply' option.** Claims Examiner - Liability IF YOU CARE, THERE'S A PLACE FOR YOU HERE For a ... Sedgwick supports and resolves property, general, auto, product and professional liability claims . We help our clients maintain brand protection in times of crisis.… more
- Carrington (Pierre, SD)
- **Come join our amazing team and work remote from home!** The Sr Claims Recovery & Analysis Analyst is responsible for performing financial reconciliation on all ... to completion that falls within the scope of the Claims Recovery & Analysis Department. + Prepare Claims...and requirements that resulted in the loss. + Keep Supervisor informed of all trends and problems including, but… more
- Guidehouse (Vermillion, SD)
- …denials + Monitors all denials for trends and issues and reports findings to supervisor . + Bills or re-bills claims as necessary. + Ensures the client ... follows all state and federal rules and regulations both billing and HIPAA. + Completes assigned special projects within the time frames given + Attend training sessions and seminars offered by the Client and Third-Party Payers. + Appropriately documents each… more
- NorthWestern Energy (Huron, SD)
- …SD, USA | Salary | Distribution Operations - SD/NE | Regular Full Time Supervisor Gas Operations Work Location : Huron, SD preferred. Other locations in South Dakota ... apply through iConnect (https://iconnect.nwe.northwesternenergy.com/Employee-Portal/?m) . About this position: The Supervisor of Gas Operations is responsible for the efficient… more
- Sanford Health (Sioux Falls, SD)
- …to work accounts throughout the entire revenue cycle. Prepares and submits claims to payers either electronically or by paper. Secures necessary medical ... appropriate department procedures to effectively submit and/or correct errors on claims . Processes and resolves denials. Uses advanced knowledge and understanding to… more
- Mathematica (Pierre, SD)
- …predictions with a large multiyear sample of Medicare beneficiaries with detailed claims data about millions of people. Mathematica's team reached the second round ... involving large administrative data sources such as state Medicaid claims and APCDs, as well as clinical data sources...obtain work outside CMS. Staff will work with their supervisor to get re-staffed, however if they are unable… more
- Mathematica (Pierre, SD)
- …large secondary data sources such as Medicaid (T-MSIS, TAF) administrative claims data to effectively answer research questions and guide decision-making about ... and practical knowledge of administrative healthcare data (eg commercial claims , hospital claims , and Medicare or Medicaid...obtain work outside CMS. Staff will work with their supervisor to get re-staffed, however if they are unable… more
- The Robison Group (Sioux Falls, SD)
- …the position will be expected to perform investigations of workers compensation claims , liability investigations, multi-line insurance claims , criminal and civil ... OPPORTUNITIES FOR GROWTH WITHIN THE COMPANY INCLUDE: SIU work, Field Supervisor , Field Operations Manager, Case Management, etc. Department Surveillance Employment… more
- Mathematica (Pierre, SD)
- …and maintaining clinical quality measures, supporting states with implementing all-payer claims databases, alternative payment models, or tools to support analytics, ... policy issues. * Familiarity with Medicare or Medicaid enrollment, claims , financial, or program data is preferred. * Excellent...obtain work outside CMS. Staff will work with their supervisor to get re-staffed, however if they are unable… more
- Walgreens (Watertown, SD)
- …pharmacist, including those to physicians. + Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and efficient ... Maintains knowledge of Company asset protection techniques, and files claims for warehouse overages (merchandise received, but not billed), shortages… more
- Interior, Bureau of Indian Affairs (Aberdeen, SD)
- …utilization reports. All other duties as assigned by the supervisor . Requirements Conditions of Employment Qualifications EXPERIENCE AND EDUCATION REQUIREMENTS: ... MUST provide transcripts or other documentation to support your educational claims . Unless otherwise stated: (1) official or unofficial transcripts are acceptable,… more
- Humana (Pierre, SD)
- …years or more years of equivalent work experience in Grievance and Appeals, Claims , Authorizations, CMS, Provider Disputes and/or healthcare industry + 1 or more ... insights/findings to Senior Leadership + 2 or more years of leadership ( Supervisor , Manager or above) experience + Strong knowledge of Medicare and Medicaid… more
- Intermountain Health (Pierre, SD)
- …execution of contracts under the supervision of the credentialing/contracting supervisor . These responsibilities include the drafting, implementation, tracking, and ... (including controlled substance DEA certification), current malpractice coverage and claims history. Queries the National Practitioner Database. 4. Prepares… more
- Interior, Bureau of Indian Affairs (Rosebud, SD)
- …or copies of agency approved certification letters based upon individual claims for coverage. Failure to provide this documentation with your application ... are suitable for telework and the selectee may be allowed to telework with supervisor approval. This position has been designated as an Incidental Operator under the… more
- Walgreens (Rapid City, SD)
- …Quality Improvement Program. + Ensures the accurate processing of insurance claims to resolve customer issues and prevent payment rejections. Follows-up with ... one's own performance, solicits for constructive feedback, and leverages Healthcare Supervisor as mentor and coach. **Communication** + Communicates with pharmacy… more
- Interior, Bureau of Indian Affairs (Pine Ridge, SD)
- …prepares, and submits special reports at the request of the supervisor and reports supporting socio-economic programs. Coordinates the installation, training, ... MUST provide transcripts or other documentation to support your educational claims . Unless otherwise stated: (1) official or unofficial transcripts are acceptable,… more
- Sunrun (Pierre, SD)
- …driver's license + Three years of this experience must be as a manager, supervisor , or equivalent position of leadership + Strong knowledge of safety regulations for ... risk assessment + Familiarity with the insurance industry, specifically Workers' Compensation claims + Working knowledge of the Microsoft Office Suite and common… more