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Insurance Claims Specialist

Posted on: June 5, 2024
Surgical Technologist

Website Prairie Lakes Healthcare System

Insurance Claims Specialist

Workplace Details

Join our team and see why Prairie Lakes Healthcare System continues to be named a Top Rural and Community Hospital year after year. Be a part of our mission to make a positive difference in the health of the patients and communities we serve by delivering accessible, high-quality, affordable, and compassionate healthcare. Prairie Lakes Healthcare System is an independent, non-profit rural healthcare system serving 10 counties in northeastern South Dakota and west-central Minnesota.

Job Summary

This position performs the submission and follow-up of insurance claims for all service lines. Ensures billing procedures are followed to maximize cash and minimize accounts receivable.

Responsibilities include:

Completes all edits to ensure claim submissions are compliant with federal and state regulations.
Performs follow-up on insurance claims to obtain maximum payment in a timely manner.
Administers timely and accurate billing and payment of all service lines
Processes all secondary claims to seek reimbursement following primary insurance payment.
Researches and resolves requests from insurance companies, patients, and third-party payors.
Resolves billing problems and assists interdepartmentally with billing issues.
Assists co-workers with problem resolution and team projects to decrease accounts receivable.
Works with the patient account specialists on private pay accounts.
Assists patients with insurance-related questions and problems.
Completes monthly billing of reoccurring accounts (i.e. kidney dialysis, radiation, chemotherapy, home health, hospice, and physician).
Other duties may be assigned.


Prairie Lakes Healthcare System offers comprehensive benefits for qualifying full-time and part-time employees. Depending on eligibility, a variety of benefits include health insurance, dental insurance, vision insurance, life insurance, a 403(b)-retirement plan, and generous paid time off to maintain a healthy home-work balance.

Additional benefits for those qualifying include:

·        Flexible Spending Account

·        Roth IRA retirement plan

·        Employee Assistance Program for mental health

·        Education Loan Program

·        Community discounts including the Prairie Lakes Wellness Center


High school diploma or general education degree (GED); or equivalent combination of education and experience. One year prior medical or general office experience is preferred. Previous billing and computer experience is desirable.

Prairie Lakes Healthcare System has a Drug Free Workplace Policy. An accepted offer will require a drug screen and pre-employment background screening as a condition of employment.

To apply for this job please visit www.prairielakes.com.