Medical Policy & Coding Support Coordinator (CPC/CPC-A preferred) Blue Cross and Blue Shield AssociationMedical Policy & Coding Support Coordinator (CPC/CPC-A preferred)Sioux Falls, SDRemotePerform 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.
NewSenior Director Coding Sanford HealthSenior Director CodingSioux Falls, South Dakota$67–$110.50 / hourCollaborates and coordinates with various Sanford Health leaders to ensure coding integrity and accurate data collection is achieved to support a seamless continuum of care, supporting provider compensation models, compliant processes, optimal reimbursement and efficient revenue cycle functions. Responsible for operational budget and strategic initiatives and formulation of Sanford Health's coding operating model and enhancement of coding related services throughout the system in order to drive and meet the goals of revenue services.
Configuration And Coding Analyst Avera HealthConfiguration And Coding AnalystSioux Falls, SD$63,960–$96,200 / yearResearch, evaluate, and implement quarterly and ongoing updates to medical coding, reimbursement methodologies, regulatory requirements, and health plan policies to ensure system configurations remain current and compliant with CMS, Medicare, Medicaid, ACA, HIPAA, NCQA, and commercial payer requirements. The position is responsible for validating claims processing and logic, maintaining coding integrity, troubleshooting configuration issues, and supporting continuous system optimization to improve automation, regulatory compliance, operational efficiency, accurate claims payment and provider coding reconsiderations.
Configuration and Coding Analyst Avera HealthConfiguration and Coding AnalystSioux Falls, SD$63,960–$96,200 / yearResearch, evaluate, and implement quarterly and ongoing updates to medical coding, reimbursement methodologies, regulatory requirements, and health plan policies to ensure system configurations remain current and compliant with CMS, Medicare, Medicaid, ACA, HIPAA, NCQA, and commercial payer requirements. The position is responsible for validating claims processing and logic, maintaining coding integrity, troubleshooting configuration issues, and supporting continuous system optimization to improve automation, regulatory compliance, operational efficiency, accurate claims payment and provider coding reconsiderations.
Coding Audit Specialist, Health Plan Sanford HealthCoding Audit Specialist, Health PlanSDRemote$21.50–$34.50 / hourThe Coding Audit Specialist position conducts quality assurance activities to ensure the accuracy and integrity of risk adjustment data submitted to the Centers for Medicare & Medicaid Services (CMS) and Department of Health Services (DHS); identifies deficiencies and provides management with an analysis of outcomes and tools for improving accuracy in coding. Responsible for auditing medical record documentation to determine appropriate diagnostic coding for services provided, taking into account the AMA CPT coding guidelines, ICD‐9 & ICD‐10 Coding Guidelines, CMS Medicare, HHS, and DHS BadgerCare Plus risk adjustment policy and Hierarchical Condition Category Coding.
Configuration and Coding Analyst AveraConfiguration and Coding AnalystSioux Falls, South Dakota$63,960–$96,200 / yearResearch, evaluate, and implement quarterly and ongoing updates to medical coding, reimbursement methodologies, regulatory requirements, and health plan policies to ensure system configurations remain current and compliant with CMS, Medicare, Medicaid, ACA, HIPAA, NCQA, and commercial payer requirements. The position is responsible for validating claims processing and logic, maintaining coding integrity, troubleshooting configuration issues, and supporting continuous system optimization to improve automation, regulatory compliance, operational efficiency, accurate claims payment and provider coding reconsiderations.
Engineer III - CICD Code Signing Automation (Remote) CrowdStrike IncEngineer III - CICD Code Signing Automation (Remote)SDRemote$120,000–$180,000 / yearAbout the Role: On the Engineering Systems team at CrowdStrike, we operate and maintain many of the systems and services that support the build, test, signing, and deployment of our software to the cloud and to our customers, as well as providing consultation, troubleshooting, and engineering support for the creation and maintenance of the pipelines that provide those functions. We base all employment decisions--including recruitment, selection, training, compensation, benefits, discipline, promotions, transfers, lay-offs, return from lay-off, terminations and social/recreational programs--on valid job requirements.
Certified Professional Coder, Special Investigations Unit (Aetna SIU) CVS Health CorpCertified Professional Coder, Special Investigations Unit (Aetna SIU)SD$43,888–$93,574 / yearThe Certified Professional Coder (CPC) will perform medical claim reviews for the Special Investigations Unit (SIU) to ensure compliance with coding practices through a comprehensive record review for medical, behavioral, transportation and other healthcare providers. Uses department resources regularly and follows workflows with minimal assistance or intervention to perform daily work to meet metrics.
NewClaim Benefit Specialist CVS Health CorpClaim Benefit SpecialistSD$17–$28.46 / hourPerforms claim documentation review, verifies policy coverage, assesses claim validity, communicates with healthcare providers and policyholders, and ensures accurate and timely claims processing. Analyzes 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.
NewCertified Coder - Corporate Office Family Health Care of SiouxlandCertified Coder - Corporate OfficeDakota Dunes, SDAssign codes to procedures and diagnoses using CPT (Current Procedural Terminology) codes, HCPCS (Healthcare Common Procedure Coding System) codes, and ICD (International Classification of Diseases) codes. Ensure codes are current, assigned accurately and sequenced correctly in each instance, in accordance with government and insurance regulations, with a high level of accuracy.
Coder II - Inpatient AveraCoder II - InpatientSioux Falls, South DakotaIP Coder II is distinguished by specific services lines which could include but not limited to the following: Surgery, NICU/PICU, Cardiovascular, Women’s Health, OB, Nursery, Behavioral Health, Orthopedics, Inpatient Rehabilitation and others as appropriate. 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.
Coder II - Inpatient Avera HealthCoder II - InpatientSioux Falls, SD$25.50–$38 / hourIP Coder II is distinguished by specific services lines which could include but not limited to the following: Surgery, NICU/PICU, Cardiovascular, Women's Health, OB, Nursery, Behavioral Health, Orthopedics, Inpatient Rehabilitation and others as appropriate. 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.
Coder III Monument Health Rapid City HospitalCoder IIIRapid City, South DakotaAccurately 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).
Senior Secretary (JPA) South Dakota State GovernmentSenior Secretary (JPA)Sioux Falls, SD$19.27–$25 / hourSelected individuals must possess the physical ability to successfully complete the practical self-defense exam, which involves the following: Lift arms above head and kick as high as own waist; Stabilize another person to accomplish a controlled take down; Use arms, palms of hands, shins, and feet to deliver blows; Withstand impact (slow speed or with a safety bag) on own body from strikes/blows; Rotate body 90 degrees with feet planted for striking with foot or using a defensive tactic; Get down on one or both knees and up again with multiple repetitions; Additionally, TB (tuberculosis) screening is required of all new employees upon hire. Excellent interpersonal, multi-tasking and administrative skills; Ability to read and comprehend the English language; Ability to effectively communicate fluently in English both verbally and in writing; Individual must be thorough, detail oriented and have the ability to work independently; Individual must be proficient in HIPAA compliance; Proficient in Microsoft Word and Excel; Basic knowledge of medical terminology; and.
Medical Records Technician (Coder) US Department of Health and Human ServicesMedical Records Technician (Coder)SD$50,460–$72,644 / yearRequired 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." 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.
Revenue Integrity Analyst Avera HealthRevenue Integrity AnalystSioux Falls, SD$25.50–$38.25 / hourRequired Education, License/Certification, or Work Experience: Associate's in Healthcare Administration, Finance, Business Analytics, or related field and/or 2-3 years of experience in healthcare revenue cycle analytics, charge auditing, or payment integrity. The analyst collaborates with clinical, billing, coding, IT, and payer relations teams to identify trends, resolve discrepancies, and drive continuous improvement across Hospital Billing (HB) and Professional Billing (PB) services.
Revenue Integrity Analyst AveraRevenue Integrity AnalystSioux Falls, South Dakota$25.50–$38.25 / hourRequired Education, License/Certification, or Work Experience: Associate's in Healthcare Administration, Finance, Business Analytics, or related field and/or 2-3 years of experience in healthcare revenue cycle analytics, charge auditing, or payment integrity. The analyst collaborates with clinical, billing, coding, IT, and payer relations teams to identify trends, resolve discrepancies, and drive continuous improvement across Hospital Billing (HB) and Professional Billing (PB) services.
Senior Secretary (JPA) State of South DakotaSenior Secretary (JPA)Sioux Falls, SD$19.27–$25 / hourSelected individuals must possess the physical ability to successfully complete the practical self-defense exam, which involves the following: Lift arms above head and kick as high as own waist; Stabilize another person to accomplish a controlled take down; Use arms, palms of hands, shins, and feet to deliver blows; Withstand impact (slow speed or with a safety bag) on own body from strikes/blows; Rotate body 90 degrees with feet planted for striking with foot or using a defensive tactic; Get down on one or both knees and up again with multiple repetitions; Additionally, TB (tuberculosis) screening is required of all new employees upon hire. Required Competencies: Excellent interpersonal, multi-tasking and administrative skills; Ability to read and comprehend the English language; Ability to effectively communicate fluently in English both verbally and in writing; Individual must be thorough, detail oriented and have the ability to work independently; Individual must be proficient in HIPAA compliance; Proficient in Microsoft Word and Excel; Basic knowledge of medical terminology; and.
NewSenior Investigator, Special Investigations Unit (Aetna SIU) CVS Health CorpSenior Investigator, Special Investigations Unit (Aetna SIU)SD$46,988–$112,200 / yearThis position will routinely handle high profile or highly sensitive matters involving cases that are national in scope, as well as, complex cases involving multi-lines of business, multiple subjects, or intricate healthcare fraud schemes. Strong communication skills, both written and oral, are necessary for the development and implementation of professional presentations for internal and external stakeholders regarding healthcare fraud matters and Enterprise approach to FWA.
Certified Medical Assistant (CMA) – Regional Drug Dependency Unit Akicita FederalCertified Medical Assistant (CMA) – Regional Drug Dependency UnitBrookings, South DakotaThis role is responsible for assisting with patient care activities, performing routine clinical tasks, managing patient records, and supporting the overall operation of the unit, ensuring compassionate, culturally sensitive care for individuals undergoing substance abuse treatment. $50,000 - $65,000 a year Position Summary The Certified Medical Assistant (CMA) will provide clinical and administrative support to the healthcare team in the Regional Drug Dependency Unit (RDDU) at the Great Plains Area facility in Winnebago, NE.