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State of South Dakota · 1 week ago

Program Assistant II

Yankton, SD

Full-time

Onsite

New Grad, Entry Level

$24.42/hr - $24.42/hr

The State of South Dakota is seeking a Program Assistant II for the Human Services Center in Yankton, SD. This role involves submitting Medicare, Medicaid, and private health insurance claims, managing patient accounts, and assisting with financial reporting and office procedures.

Government

No H1B

Responsibilities

Submits Medicare, Medicaid and private health insurance claims for patients who reside at the Human Services Center

Collecting billing information from various sources to determine the appropriate CPT and ICD codes to apply to claims

Entering appropriate information to claims software or paper forms

Electronically filing or mailing the claims

Receives the explanation of benefits (EOB), remittance, or payment and adjusts patient accounts accordingly

Dispute and resolve denials when necessary

Tracks claims submitted and payments for accounts receivable purposes

Reports revenue, and claim status information on a monthly basis

Performs accounts payable activities to include approving and/or coordinating the payment of outside medical services for patients at the Human Services Center

Assists the Finance Manager by evaluating, revising, and/or establishing new work processes to determine the most effective and efficient office procedures

Assists the Finance Manager with monthly and year-end reports by gathering statistical data from various sources within the Human Services Center

Will perform other duties as assigned

Qualification

CPTICD codesFiling insurance claimsElectronic medical recordsCMS rulesRegulationsMaintaining relationshipsIndependent judgementNavigating computer systemsProblem solvingEffective communication

Required

Knowledge of CPT and ICD codes

Experience with electronic medical records

Knowledge of Centers for Medicare and Medicaid (CMS) rules and regulations

Experience with filing insurance claims

Familiarity with applicable state and federal laws

Skill to navigate computer systems and applications, including using a test environment to process transactions with new or expanded computer programs

Ability to exercise independent judgement in evaluating situations and making decisions

Ability to problem solve

Ability to communicate information effectively

Ability to maintain effective working relationships with providers, department officials and the public