AgropurNewReliability Specialist AgropurReliability SpecialistLake Norden, SD$84,200–$105,200Initiates and leads risk-based methodologies such as Equipment/System Criticality Analysis (CA), Failure Modes, Effects, and Criticality Analysis (FMECA), and Reliability-Centered Maintenance (RCM). Provides technical assistance to maintenance supervisors, planners, and maintenance employees in the form of specific technical data on system configuration and performance as a backup for the Maintenance Specialist.
Black Hills Regional EYE Institute Llp.Senior Medical Billing Specialist Black Hills Regional EYE Institute Llp.Senior Medical Billing SpecialistRapid City, SDStrong ability to problem solve using multiple means such as office training manuals, internal e-mail guidelines, payer websites, internet search features etc. In addition to you will also be working with patients regarding outstanding bills, and handling incoming patient and insurance calls, and assisting with billing discrepancy/issues.
Blue Cross and Blue Shield AssociationNewHealth Services Coding Analyst (CPC Required) Blue Cross and Blue Shield AssociationHealth Services Coding Analyst (CPC Required)Sioux Falls, SDRemoteWork directly with Health Services leadership, Medical Review staff, leadership within Claims and Customer/Provider Services and Network Engagement, Medical Directors to provide medical coding expertise and PGE rule knowledge to resolve complex claims and/or customer and provider issues. Contribute to the achievement of corporate and UM Product Team objectives by independently serving as primary points of contact and UM Product Team Subject Matter Expert/Guest Star to provide expertise to support the various claims processing systems, including but not limited to PGE rules and table maintenance (FACETS and STAR).
Ophthalmology LTDMedical Coder Ophthalmology LTDMedical CoderSioux Falls, SDOphthalmology LTD delivers treatment for cataracts, glaucoma, and diabetic eye disease, as well as cornea transplants, oculoplastic surgery, retina surgery, vitreoretinal surgery, and pediatric eye care in Sioux Falls. Minimum of 2 years of medical coding experience in a physician office setting or equivalent with knowledge of various medical payer practices and insurance laws/guidelines (Medicare, Medicaid, Work Comp, VA, and other third-party payers).
CVS Health CorpNewClaim Benefit Specialist CVS Health CorpClaim Benefit SpecialistWork At Home, SD$17–$28.46 / hourAnalyzes claims data and generate reports to identify trends, patterns, or areas for improvement to help inform process enhancements, policy changes, or training needs within the claims processing department. Performs claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing.
TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd) TriWest Healthcare AllianceProgram Integrity Clinical Specialist (RN or PA Req'd)Sioux Falls, SDRemoteFull timeTechnical Skills: Knowledge of TRICARE policies and procedures, knowledge of Case Management, Utilization Management, and Quality Management practices and principles, and knowledge of Managed Care concepts, alternative care treatments, and community resources. • Research and investigate medical issues as they relate to potential fraud and abuse cases, to include perform anti-fraud and abuse pre-payment reviews or post-payment reviews.
US Department of Health and Human ServicesNewMedical Records Technician (Coder) US Department of Health and Human ServicesMedical Records Technician (Coder)Kyle, SD$55,882–$72,644 / yearMINIMUM QUALIFICATIONS: 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: GS-08: One (1) year of specialized experience comparable in difficulty and responsibility to the GS-08 grade level with the knowledge, skills and abilities to successfully perform the duties of this position. Refer to BIA-4432 link: Verification of Indian Preference for Employment in the BIA and IHS When an Indian Preference candidate possesses Veterans preference the rules regarding Veterans preference apply under ESEP and the applicant must provide documentation in order to receive preference.
Army National Guard of the United StatesNew68W Health Care Specialist Army National Guard of the United States68W Health Care SpecialistVermillion, SD$200–$250 / weekYou will address the health care needs of civilians after natural disasters or civil emergencies; treat injuries and illnesses suffered by Soldiers through the administration of immediate emergency care and ongoing care; and support and manage medical readiness, supplies, and equipment. Through your training, you will develop the skills and experience to enjoy a civilian career with civilian hospitals, clinics, nursing homes, or rehabilitation centers.
Army National Guard of the United StatesNew92Y Unit Supply Specialist - Warehouse Manager Army National Guard of the United States92Y Unit Supply Specialist - Warehouse ManagerMadison, SD$200–$250 / weekThrough your training, you will develop the skills and experience to enjoy a civilian career as a stock control clerk, parts clerk, or storekeeper with factories, repair shops, department stores or government warehouses and stockrooms. You will: ensure that all documents are prepared and organized; maintain automated systems; secure and control weapons and ammunition; and schedule and provide maintenance for weapons.
Monument Health.RN | Medical/Surgical Monument Health.RN | Medical/SurgicalSpearfish, SD$35–$43.75 / hourProficiently uses applicable technology and software to: • Support and document nursing activities and patient care • Access other work-related applications necessary to be an engaged and active associate of the organization, such as company email, iLearn modules, employee engagement surveys, benefits and compensation information, and policies and procedures • Continuously seeks out opportunities to improve the quality of patient care delivery through innovative and creative problem solving • All other duties as assigned. Required: • Education - Completion of a nursing education program that is approved by a board of nursing • Certifications - Basic Life Support (BLS) Certification - American Heart Association (AHA) - Within 60 days of hire or transfer; Registered Nurse (RN) - South Dakota Board of Nursing.
Army National Guard of the United StatesNew92A Automated Logistical Specialist - Supply Chain Army National Guard of the United States92A Automated Logistical Specialist - Supply ChainRapid City, SD$200–$250 / weekMajor duties include: establishing and maintaining records (stock lists, inventory, material control, etc.), maintaining stock locator system and administering document control procedures, processing requests and turn-in documents, performing prescribed load-list and shop-stock list duties in manual and automated supply applications, and operating material-handling equipment. Age Requirements: Must be between the ages of 17 and 35 purchasing manager buyer purchasing agent CSCP APICS wholesale retail merchandise managers commercial clerk junior assistant CPM CPSM CPP CPPM CPPB CPPO.
Monument Health.RN | Medical Monument Health.RN | MedicalRapid City, SD$35–$43.75 / hourYou will be an active contributor in the prevention or resolution of illness, disability or injury, alleviation of suffering, and advocacy in the care of individuals in conjunction with interdisciplinary teams of healthcare providers, family members, and support systems. Required: Certifications - Basic Life Support (BLS) Certification - American Heart Association (AHA) - Within 60 days of hire or transfer; Registered Nurse (RN) - South Dakota Board of Nursing.
Youth & Family ServicesMiddle School Youth Program Specialist (Boys) Youth & Family ServicesMiddle School Youth Program Specialist (Boys)Rapid City, SDPlan informal educational activities for children that incorporate a broad-based knowledge in areas of careers and life planning, health/sexuality, leadership and community action, sports and adventure, self-reliance and life skills and culture/heritage. Supervisory and organizational skills and ability to relate to co-workers, parents and the general public.
West River Mental HealthClinical Specialist (Case Manager) West River Mental HealthClinical Specialist (Case Manager)Rapid City, SDCoordinate the teaching of daily living skills: this includes but not limited to; grocery shopping, hygiene, maintaining clean housing, utilizing public transportation, maintaining self-care, exploring employment opportunities, instruct clients in the act of self-administration of prescription and nonprescription medication. West River Mental Health has been providing mental health care in Western South Dakota since 1948 and is the largest, most advanced community mental healthcare facility in the region.
US Department of Health and Human ServicesSupervisory Safety and Occupational Health Specialist (Safety Officer) US Department of Health and Human ServicesSupervisory Safety and Occupational Health Specialist (Safety Officer)Pine Ridge, SD$106,437–$138,370 / yearCompleted a undergraduate or higher level degree in a major -- safety or occupational health fields (safety, occupational health, industrial hygiene), or degree in other related fields that included or was supplemented by at least 24 semester hours of study from among the following (or closely related) disciplines: safety, occupational health, industrial hygiene, occupational medicine, toxicology, public health, mathematics, physics, chemistry, biological sciences, engineering, and industrial psychology. Required as applicable for the purposes of specific eligibility and appointment claim(s), and position requirements: Indian Preference Applicants: If claiming Indian preference, applicants must provide a completed copy of the Form BIA-4432, "Verification of Indian Preference for Employment in the BIA and IHS Only."
Monument Health.340(b) Specialist Monument Health.340(b) Specialistrapid city, SD$23.48–$29.35 / hourEssential Functions: Collaborates with the finance department to monitor changes that could affect 340(b) qualification such as changes in the points of service position on the cost report, any changes in institutional ownership or related joint ventures and any variations or negative trends in DSH percentages. Routinely monitors utilization records, 340(b) purchasing accounts to ensure software or tools are working properly and accurately, performing audits and both internal and external compliance assessments to validate processes.
PREMIER Bankcard, LLCHuman Resources Specialist PREMIER Bankcard, LLCHuman Resources SpecialistSioux Falls, SDFull timeServe as a trusted partner to assist with any aspect of the employee life-cycle, including recruitment, general benefits and leave questions, onboarding or offboarding processes as well as special projects, as assigned. Resolves inquiries from internal or external customers by providing information on policies and/or procedures, referring the most complex issues to dedicated subject matter experts within HR.
MCI CareersNewSenior Business Development Specialist MCI CareersSenior Business Development SpecialistSouth DakotaMCI organically grows, acquires, and operates companies that have synergistic products and services portfolios, including but not limited to Automated Contact Center Solutions (ACCS), customer contact management, IT Services (IT Schedule 70), and Temporary and Administrative Professional Staffing (TAPS Schedule 736), Business Process Management (BPM), Business Process Outsourcing (BPO), Claims Processing, Collections, Customer Experience Provider (CXP), Customer Service, Digital Experience Provider (DXP), Account Receivables Management (ARM), Application Software Development, Managed Services, and Technology Services, to mid-market, Federal & enterprise partners. MCI now employs 10,000+ talented individuals with 150+ diverse North American client partners across the following MCI brands: MCI BPO, MCI BPOaaS, MarketForce, GravisApps, Gravis Marketing, MarchEast, Mass Markets, MCI Federal Services (MFS), OnBrand24, The Sydney Call Center, Valor Intelligent Processing (VIP), BYC Aqua, EastWest BPO, TeleTechnology, and Vinculum.
O'Reilly Automotive IncParts Specialist O'Reilly Automotive IncParts Specialistberesford, SDSKILLS/EDUCATION/KNOWLEDGE/EXPERIENCE/ABILITIESRequired: Ability to quickly match alphanumeric sequencesAbility to provide outstanding, friendly and professional customer serviceMust be able to multitask, handling customers on the phone and in the store at the same timeDesired: Familiar with automotive parts, cataloging, weatherly index system, and automotive sales or serviceASE certificationFluency in multiple languages (Spanish is highly desired)O'Reilly Auto Parts has a proven track record of growth and stability. Provide excellent service to customers calling the store on the phone by answering all calls according to company policy, accurately looking up parts and quote prices, recommending premium and related items, and offering the Low-Price Guarantee.
HealthfirstAppeals and Grievances Clinical Specialist HealthfirstAppeals and Grievances Clinical SpecialistSD$83,100–$120,360 / yearPosition Summary: The Appeals & Grievances (A&G) unit manages Healthfirst member complaints, grievances and appeals that are presented by the member or provider pertaining to the authorization of or delivery of clinical and non-clinical services. Prepare cases for Medical Director Review ensuring that all pertinent information (i.e. case summary, contract information, internal and external responses, diagnosis, and CPT codes and descriptions) has been obtained during investigation and is presented as part of the case.
MaximusReporting Specialist MaximusReporting SpecialistSioux Falls, SDFull timeMaximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at applicantaccom@maximus.com.
Monument Health.Coder III Monument Health.Coder IIIrapid city, SD$24.19–$30.24 / hourAccurately and efficiently codes and abstracts comprehensive acute care inpatient, rehabilitation inpatient, outpatient surgery, swing bed, long term care, ancillary services and short stay observation patient records according to official coding guidelines for accurate coding and benchmarks for productivity. Certifications - Certified Coding Specialist (CCS) - American Health Information Management Association (AHIMA); Certified Professional Coder - Apprentice (CPC-A) - American Academy of Professional Coders (AAPC); Registered Health Information Administrator (RHIA) - American Health Information Management Association (AHIMA); Registered Health Information Technician (RHIT) - American Health Information Management Association (AHIMA).
Ceribell, IncNewSenior Manager, Reimbursement - Central (remote) Ceribell, IncSenior Manager, Reimbursement - Central (remote)North Sioux City, SDRemote$184,000–$210,000 / yearThe Ceribell System is a novel, point-of-care electroencephalography ("EEG") platform specifically designed to address the unmet needs of patients in the acute care setting, and is being used in hundreds of community hospitals, large academic facilities and major IDN's across the country. Data Analysis and Reporting: Utilize reimbursement data, claims data, and other relevant sources to perform data analysis and generate reports on reimbursement trends, payment patterns, and financial outcomes.
Sanford HealthNewCompliance Auditor Sanford HealthCompliance AuditorSioux Falls, SD$19–$30.50 / hourDemonstrates an advanced knowledge and skill in analyzing patient records to identify non-conformances in Current Procedural Terminology (CPT), International Classification of Diseases, Tenth Edition (ICD-10), and Healthcare Common Procedure Coding System (HCPCS) code assignment. Certification in one of the following is required: Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), Certified Professional Coder (CPC) or an equivalent.
TriWest Healthcare AllianceSr Claims Reviewer TriWest Healthcare AllianceSr Claims ReviewerSioux Falls, SDRemoteFull timeProficient with claim and coding tools such as Supercoder, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. This role will serve as a SME and will collaborate with Claims leadership, Training, the Claims Content Specialist, and internal business partners to ensure procedures and training materials are accurate and complete.
CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)SD$46,988–$122,400 / yearAnticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $46,988.00 - $122,400.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. Exercises independent judgement and uses available resources and technology in developing evidence, supporting allegations of fraud and abuse Required Qualifications 3 years working on health care fraud, waste, and abuse investigatory and audits required.
Sammons Financial GroupInformation Reporting Payables Analyst Sammons Financial GroupInformation Reporting Payables AnalystSioux Falls, South Dakota$40,223–$67,039 / yearEnsure all invoices, expense reports and credit card statements are paid within proper guidelines ensuring all discounts are received and they are accurately coded in the proper company expense accounts and cost centers to ensure compliance with an Accountable Plan according to IRS regulations allowing proper deductions; maintain any travel advance accounts to ensure proper reimbursement is received with all proper documentation in addition to ensuring proper Record Information Management procedures; complete of all monthly/quarterly administrative billings, prepare reports/transmittals, monthly balancing of subsidiary accounts and any other reports requested by management. • Obtain and possess a working knowledge of the systems that feed into the Company Tax System; includes agent administration systems (LifeCom, Agency, Policylink, PPlus, Accounts Payable, and RPS Disbursements), and a thorough understanding of all “jobs” that are in production, as well as test; utilize this knowledge to determine root cause of problems and take appropriate problem resolution actions in a timely manner.