div style="background-color:rgb( 255 , 255 , 255 );color:rgb( 38 , 35 , 33 );font-family:'circular' , '-apple-system' , 'blinkmacsystemfont' , 'segoe ui' , 'roboto' , 'oxygen' , 'ubuntu' , 'cantarell' , 'fira sans' , 'droid sans' , 'helvetica neue' , sans-serif;font-size:16px;font-style:normal;font-weight:400;letter-spacing:normal;outline:none;text-indent:0px;text-transform:none;white-space:normal;word-spacing:0px">HOURS: 40 hours week.
At LSS , we are committed to upholding the following values in all aspects of our work:
Compassionate – We engage with empathy and provide non-judgmental services.
While training new claims examiners, fulfill all claims examiner functions as listed below: Ensures accurate and complete claims processing by verifying required documentation, collaborating with relevant parties to obtain necessary information, and confirming system adjudication aligns with plan provisions. These states include: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Georgia, Hawaii, Idaho, Iowa, Kansas, Maryland, Massachusetts, Michigan, Nebraska, Ohio, Pennsylvania, Texas, Utah, Vermont, and Washington State.
p>GS-08: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the next lower grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: interpreting and applying federal, state, Tribal, and third-party program regulations to determine eligibility and ensure compliance for programs such as Purchase Referred Care, Medicare, Medicaid, Affordable Care Act, Veterans Affairs Healthcare, and other alternate resources; conducting in-depth patient interviews to assess eligibility, verify coverage, and complete applications; registering eligible patients in various assistance programs; resolving claim denials and eligibility issues through coordination with patients, healthcare providers, and outside agencies; reviewing Medicaid eligibility information and supporting billing requirements; and utilizing effective oral and written communication to explain program requirements, provide referrals, and resolve complex patient service issues. MINIMUM QUALIFICATIONS:
GS-06: Your resume must demonstrate at least one (1) year of specialized experience equivalent to at least the GS-05 grade level in the Federal service obtained in either the private or public sector performing the following type of work and/or tasks: determining patient eligibility for alternate resources programs; interpreting and applying Medicare, Medicaid, VA, and other third-party payer policies and procedures; conducting patient interviews to identify available healthcare coverage and funding sources; assisting patients with enrollment and claims processes; researching and resolving eligibility, denial, and reimbursement issues; maintaining effective working relationships with patients and resource agencies; and safeguarding confidential patient information in accordance with Privacy Act and HIPAA requirements.
Rapid City, SD 30+ days ago
Will be responsible for researching and synthesizing current healthcare intelligence and trend data to identify opportunities for improvement and support the implementation of improvement strategies. Prepare reports and oversee departmental documentation in accordance with various regulatory agencies, including but not limited to AABB, CAP, SDDOH, TJC and CMS.
Functions as a subject matter expert for payer credentialing and enrollment representatives to ensure health system providers are fully credentialed and loaded as participating providers with all applicable government and commercial payers. This position is accountable for maintaining and disseminating accurate plan participation status to operational and billing internal departments to maximize collections in the revenue cycle management process.
Rapid City, South Dakota 30+ days ago
div>Current Employees:
If you are a current Monument Health employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage. .
Sedentary work - Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body.
Sioux Falls, SD 30+ days ago
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. The RN works collaboratively with the team members, nursing departments, outlying facilities, as well as the physicians to facilitate efficient movement of patients throughout the footprint.
Sioux Falls, SD 11 days ago
p class="isSelectedEnd">As a Project Coordinator , you'll serve as the connection between our homeowners, production teams, and service technicians, ensuring projects are scheduled efficiently, communication is clear, and every customer receives the outstanding experience we're known for. As a family-owned company, we believe great customer service starts behind the scenes with organized, proactive, and detail-oriented team members who keep every project running smoothly.
Sioux Falls, SD 30+ days ago
p>The specialty clinics include chiropractic, cardiology, mental health, psychiatric care and medication management, pain management, podiatry, ophthalmology, sleep studies, urology, vascular, orthopedics, obstetrics, gynecology, and general surgery. A bachelor’s degree in Marketing, Graphic Design, Communications, or a related field is preferred, along with at least one year of marketing, communications, or graphic design experience (healthcare experience is a plus).
Sioux Falls, SD 23 days ago
This position serves as a key community liaison, building partnerships and delivering impactful training to schools, youth-serving organizations, healthcare providers, law enforcement, faith communities, and other community stakeholders throughout Sioux Falls and surrounding communities. This position plays a critical role in raising awareness about human trafficking, strengthening community partnerships, and delivering meaningful training programs that help protect vulnerable youth and adults.
p>PREFERRED QUALIFICATIONS: Relevant research experience of 2 years or more working on research projects or grants in the capacity of student researcher, research coordinator, project manager or other related work; At least 2 years of experience doing community outreach and/or community education; Experience with collecting data from people/patients for tracking or informational purposes (may include research purposes); Experience writing grants and project status reports; At least 2 years of experience working in a clinical setting; Experience with data analysis (quantitative or qualitative); Experience with statistical software; and. MINIMUM QUALIFICATIONS:
Master's degree in one of the following disciplines: Health-related Outcomes Research, Epidemiology, Health Services Research, Social and Administrative Sciences, Public Health or a related filed completed by start date OR an earned Bachelor's degree in a related field with 2-3 years of relevant professional experience including healthcare experience, community health worker, social worker or community development completed by start date; At least one year of relevant research experience working on research projects or grants in the capacity of student researcher, research coordinator, project manager, or other related work.
Rapid City, South Dakota 30+ days ago
b>Help build our new community hospital from the ground up! Exceptional Healthcare seeks a dedicated Medical Supply Support Coordinator to ensure our facility operates at peak efficiency. Exceptional Healthcare is building a new Community Hospital , a state-of-the-art facility bringing high-quality care to Rapid City and surrounding communities.
Rapid City, South Dakota 10 days ago
div>Current Employees:
If you are a current Monument Health employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage. . Functions as a subject matter expert for payer credentialing and enrollment representatives to ensure health system providers are fully credentialed and loaded as participating providers with all applicable government and commercial payers.
Perform monthly medical policy coding analyses and SAP BusinessObjects reports to identify and recommend necessary changes based on comparison to BCBSA reference medical policies, sentinel commercial health plan benchmarks and utilization patterns and implementation of claim system edits to support its intent. Support Medical Policy Team's operations, including creating and managing monthly Medical Policy production timelines, quarterly production timeline for N/R/D Code processing, maintaining Medical Policy material distribution lists, and filing external appeals.
Garretson, South Dakota 30+ days ago
p style="margin:0in;font-size:12pt;font-family:'aptos' , sans-serif">• Participate in interdisciplinary meetings including utilization review, quality assurance, resident care conferences, admissions, department head meetings, and community education planning. • Must hold a degree in Physical Therapy, Physical Therapist Assistant, Occupational Therapy, Occupational Therapy Assistant or Speech-Language Pathology from an accredited institution.
Rapid City, SD 23 days ago
Located in Rapid City, South Dakota, the Rehabilitation and Critical Care Hospital of the Black Hills is equipped with 36 inpatient medical rehabilitation beds and 18 long-term acute care beds. At the Rehabilitation and Critical Care Hospital of the Black Hills, we are dedicated to delivering advanced treatments and compassionate care to help our patients recover and regain their independence.
Sioux Falls, SD 11 days ago
p>As a LPN Intake Coordinator, here's a big-picture view of what you'll do:
Rapid City, SD 30+ days ago
b>Help build our new community hospital from the ground up! Exceptional Healthcare seeks a dedicated Medical Supply Support Coordinator to ensure our facility operates at peak efficiency. Exceptional Healthcare is building a new Community Hospital , a state-of-the-art facility bringing high-quality care to Rapid City and surrounding communities.
Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; detail-oriented. High Intensity Environment: Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.
The ideal candidate possesses strong knowledge of EMS operations, ambulance equipment and procedures, and applicable state regulations, along with the ability to communicate effectively, manage priorities, and work collaboratively with diverse stakeholders. In this role, the Rural Health and Emergency Services Statewide Coordinator oversees the licensing and regulatory compliance of ambulance services, conducts on-site inspections, and provides technical guidance to service leadership.
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. Notifies members of the IDT of changes or additions to monthly Care Plan Meeting schedule, for new admission, change of condition or interim meetings.
Sioux Falls, SD 19 days ago
li>Identifies and effectively communicates pertinent patient information to the health care team, patients and families in a clear, concise and timely manner, from one level or location of care to another for complete patient continuum of care while ensuring appropriate utilization of resources. The RN Coordinator has primary day-to-day responsibility of assuring workflow turnaround times are met, daily tracking of workflow, communication to the team, staff scheduling coordination, and special projects.
Sioux Falls, South Dakota 30+ days ago
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.
