NewCoding Data Quality Auditor CVS Health CorpCoding Data Quality AuditorSD$18.50–$38.82 / hourResponsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical documentation in accordance with all State and Federal regulations and internal policies and procedures. Proficient in abstraction and assignment of accurate medical codes for diagnoses as documented by physicians and other qualified healthcare providers in the office and/or facility setting.
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.
NewVice President, Revenue Cycle, Coding and HIM Sanford HealthVice President, Revenue Cycle, Coding and HIMSioux Falls, SDPartners with physician leaders, clinical teams, operational executives, finance, technology, compliance, and revenue cycle peers to strengthen alignment between clinical documentation, patient care delivery, and financial outcomes. Extensive progressive leadership experience within healthcare revenue cycle, health information management, coding, clinical documentation improvement, revenue integrity, healthcare operations, or related functions required.
Medical Claims Specialist State of South DakotaMedical Claims SpecialistSioux Falls, SD$19.29–$21 / hourThe Ideal Candidate Will Have: experience processing medical, insurance, or healthcare claims; experience in medical billing, medical coding, revenue cycle, healthcare reimbursement, or provider office operations (preferred); knowledge of medical terminology (preferred); familiarity with Medicaid, Medicare, commercial insurance, or other healthcare reimbursement programs (preferred); respond promptly and courteously to incoming phone calls from medical providers, billing agents, and recipients regarding correct Medicaid claim submission, claim status, and reimbursement through billing guidelines, policies, and procedures; review claim records, system information, policy manuals, and fee schedules to identify submission errors, missing data, or processing discrepancies; process medical claims that stop for manual review between incoming calls; provide clear and courteous guidance over the phone, helping callers resolve issues related to denials, adjustments, coordination of benefits, and prior authorizations; collaborate with other internal departments to address complex claims or policy questions that require further investigation or higher-level approval; monitor and track claim statuses, follow up on unresolved cases, and ensure that documentation is updated accurately and completely; educate providers on self-service tools such as electronic eligibility verification systems, diagnosis/procedure code lookup tools, claims submission portals, and online manuals/fee schedules; maintain confidentiality and security of sensitive health and financial data in compliance with HIPAA and state regulations on confidentiality and security of health and finance data; stay updated on changes to Medicaid policies, billing codes, and claim system processes. This role works directly with healthcare providers, medical billing offices, and Medicaid recipients to resolve claim issues, explain billing policies, and ensure accurate and timely claims processing.
Medical Claims Specialist South Dakota State GovernmentMedical Claims SpecialistPierre, SD$19.29–$21 / hourexperience processing medical, insurance, or healthcare claims; • experience in medical billing, medical coding, revenue cycle, healthcare reimbursement, or provider office operations (preferred); • knowledge of medical terminology (preferred); • familiarity with Medicaid, Medicare, commercial insurance, or other healthcare reimbursement programs (preferred); • respond promptly and courteously to incoming phone calls from medical providers, billing agents, and recipients regarding correct Medicaid claim submission, claim status, and reimbursement through billing guidelines, policies, and procedures; • review claim records, system information, policy manuals, and fee schedules to identify submission errors, missing data, or processing discrepancies; • process medical claims that stop for manual review between incoming calls; • provide clear and courteous guidance over the phone, helping callers resolve issues related to denials, adjustments, coordination of benefits, and prior authorizations; • collaborate with other internal departments to address complex claims or policy questions that require further investigation or higher-level approval; • monitor and track claim statuses, follow up on unresolved cases, and ensure that documentation is updated accurately and completely; • educate providers on self-service tools such as electronic eligibility verification systems, diagnosis/procedure code lookup tools, claims submission portals, and online manuals/fee schedules; • maintain confidentiality and security of sensitive health and financial data in compliance with HIPAA and state regulations on confidentiality and security of health and finance data; • stay updated on changes to Medicaid policies, billing codes, and claim system processes. This role works directly with healthcare providers, medical billing offices, and Medicaid recipients to resolve claim issues, explain billing policies, and ensure accurate and timely claims processing.
Medical Billing Specialist Slingsby & Huot Eye AssociatesMedical Billing SpecialistRapid City, SDAt Slingsby & Huot Eye Associates, we are dedicated to providing the highest level of eye care services to our patients in Rapid City and the surrounding areas. From comprehensive eye exams to advanced surgical procedures, we offer a wide range of services to meet our patients' needs.
NewBilling and Insurance Specialist/Medical Office Midwest Ear, Nose & ThroatBilling and Insurance Specialist/Medical OfficeSioux Falls, SDThis role will verify hearing aid benefits and prepare patient estimates and prior authorizations, establish patient payment plans within approved guidelines, and provide exceptional customer service by assisting patients and insurance carriers with billing inquiries. This position is responsible for ensuring accurate charge entry, payment posting, and account reconciliation while supporting efficient revenue cycle operations.
NewCertified 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.
Medical 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).
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.
Claims Recoup & Collect Anlyst TriWest Healthcare AllianceClaims Recoup & Collect AnlystSioux Falls, SDRemoteFull timeUnder limited supervision, manages and performs claims department activities related to recoupments and collections, including validation of recoupment setup, conducting collections calls with providers, establishing payment arrangements, tracking and trending outstanding recoupments, establishing payment arrangements, and coordinating collections activities with other departments. Proficient 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.
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 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).
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.
Certified Medical Assistant (CMA) – Regional Drug Dependency Unit Akicita FederalCertified Medical Assistant (CMA) – Regional Drug Dependency UnitSioux Falls, 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.
Graphic Designer Sammons Financial GroupGraphic DesignerSioux Falls, South Dakota$44,498–$74,162 / yearFull timeManage business forms and marketing materials maintenance, including: • Building and maintaining branded business forms (e.g., applications, enrollment/change requests, claims/service forms, disclosures, rate sheets) as print PDFs, translating complex requirements into clear, usable, accessible layouts that reflect the brand. Proficient in Mac computer systems using Adobe Creative Suite—Photoshop, Illustrator, InDesign, Adobe XD, Acrobat Pro, Dreamweaver; CSS; HTML; responsive web design; User Experience design; interactive landing pages; and typography.
Supervisor, Claims Admin TriWest Healthcare AllianceSupervisor, Claims AdminSioux Falls, SDRemoteFull timeThe Supervisor, Claims Administration interacts and collaborates frequently with beneficiaries, Veterans, providers, sub-contractors, the Government, and internal business partners to resolve issues, respond to inquiries, and improve processes. Organizational Skills: Ability to organize people or tasks, adjusts to priorities, learns systems within time constraints and with available resources; detail-oriented.
Clinical Quality Specialist - Canton Medical Center - Full Time Sanford HealthClinical Quality Specialist - Canton Medical Center - Full TimeCanton, SD$24–$38.50 / hourGraduate from a nationally accredited nursing program preferred, including, but not limited to, Commission on Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN), and National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Currently holds an unencumbered RN license with the State Board of Nursing where the practice of nursing is occurring and/or possess multistate licensure if in a Nurse Licensure Compact (NLC) state.
Sr 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.
Claims Reviewer TriWest Healthcare AllianceClaims ReviewerSioux Falls, SDRemoteFull timeProficient with claim and coding tools and resources, Clinical Decision Support Tool, Current Procedural Terminology, Health Care Financing Administration Common Procedure Coding System, and American Dental coding. Provides clinical and coding-related information to medical director, providers, peer reviewers, Claims Administration, Program Integrity, Quality Management, and/or the Claims Subcontractor as needed.
Field Reimbursement Manager - Kidney (Midwest - ND, SD, WI, MN) Vertex Pharmaceuticals IncField Reimbursement Manager - Kidney (Midwest - ND, SD, WI, MN)SD$136,000–$204,000 / yearKey Duties and Responsibilities: Compliantly establish strong connections with key nephrology office personnel, including members of the care team and administrative staff responsible for prior authorizations and patient access to specialty medications, to support patient access to prescribed medications. At Vertex, our Total Rewards offerings also include inclusive market-leading benefits to meet our employees wherever they are in their career, financial, family and wellbeing journey while providing flexibility and resources to support their growth and aspirations.
Utilization Clinical Reviewer TriWest Healthcare AllianceUtilization Clinical ReviewerSioux Falls, SDRemoteFull timeApplies clinical knowledge to make determinations for preauthorization, inpatient and continued stay reviews for Behavioral Health and Medical/Surgical requests to establish medical necessity, benefit coverage, appropriateness of quality of care, and length of stay or care plan. The Utilization Management Clinical Review nurse reviews and makes decisions about the appropriateness and level of beneficiary care being provided in an effort to provide cost effective care and ensure proper utilization of resources.
NewBilling Assistant United Surgical Partners International IncBilling AssistantSioux Falls, SDPrint all paper claims from Vision/AdvantX, review claims for accuracy including modifiers, payers, claims addresses, and additional pertinent information included. Gather all supporting documentation such as operative notes, block reports, implant logs, etc. which MUST be attached with mailed claims.
Billing Associate Avera HealthBilling AssociateSioux Falls, SD$18.50–$24.25 / hourTo 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. Verifies, submits and adjudicates patient billing information, submits necessary claim forms and reconciles accounts receivable remittances appropriately and documents tracking information to customer''s accounts.
Billing Associate AveraBilling AssociateSioux Falls, South DakotaTo 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. Verifies, submits and adjudicates patient billing information, submits necessary claim forms and reconciles accounts receivable remittances appropriately and documents tracking information to customer's accounts.
Dental Billing and Collections Associate Horizon HealthDental Billing and Collections AssociateHoward, South DakotaOur Culture: Horizon Health’s culture is built on the Non-Negotiable attributes of Respect, Teamwork, Accountability, Integrity, Professionalism, and being Rurally Focused — ensuring every team member upholds these attributes daily. Horizon Health offers a collaborative, team-oriented work environment focused on meeting the needs of individual patients while supporting and contributing to the health and wellness of our communities.
Senior 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.
Medical Director - ENT CVS Health CorpMedical Director - ENTSD$174,070–$374,920 / yearLeads all aspects of utilization review/quality assurance, directing case management Provides clinical expertise and business direction in support of medical management programs through participation in clinical team activities Acts as lead business and clinical liaison to network providers and facilities to support the effective execution of medical services programs by the clinical teams Responsible for predetermination reviews ad reviews of claim determinations, providing clinical, coding, and reimbursement expertise. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
Medicare Programs Clinical Lead - SD, ND, NE Sanford HealthMedicare Programs Clinical Lead - SD, ND, NESioux Falls, SD$31–$49.50 / hourGraduate from a nationally accredited nursing program preferred, including, but not limited to, Commission on Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN), and National League for Nursing Commission for Nursing Education Accreditation (NLN CNEA). Leads clinical operations of Medicare programs with a primary focus in model of care development and delivery, healthcare effectiveness data and information set (HEDIS), Medicare star rating, Chronic Care Improvement (CCIP) and risk adjustment.
Senior Software Development Engineer CVS Health CorpSenior Software Development EngineerSD$83,430–$222,480 / yearCVS Health Digital is looking for hands-on, passionate people who want to join a high energy and growing team to make a difference in customers' lives and who want to be on the forefront of digital innovation that aims to reinvent what a pharmacy and a health care company can be in the digital world. Currently, we are seeking a Senior Software Development Engineer with deep expertise in Java/JEE, Spring Boot, RESTful microservices, and Kafka to lead the design and development of scalable, secure cloud-native solutions.
Informatics Consultant CVS Health CorpInformatics ConsultantSD$43,888–$102,081 / year1+ year(s) computer skills and knowledge of Microsoft Word, Excel, PowerPoint and Adobe Acrobat Pro experience with reporting platforms such as: Big data analytics, data mining, and Tableau. Become a subject matter expert for Client Management, clients and brokers related to our internal analytics tool and their client's data.
Senior Software Engineer, Cloud Platforms Puck Enterprises Inc.Senior Software Engineer, Cloud PlatformsSDNET ecosystem, including modern application architecture, asynchronous programming, dependency injection, and service-oriented design Strong hands-on experience designing, building, deploying, and supporting applications or services in Microsoft Azure Demonstrated experience designing scalable REST APIs, service integrations, and distributed systems with attention to reliability, security, and maintainability Strong understanding of relational databases, SQL, data modeling, query optimization, and ORM frameworks such as Entity Framework or Entity Framework Core Experience with CI/CD, source control, automated testing, and modern DevOps practices in a team-based engineering environment Experience using AI-assisted development tools to improve software design, coding efficiency, testing, and debugging while maintaining code quality and sound technical judgment Experience leading technical design discussions and making architectural tradeoff decisions across multiple services or components Strong debugging, performance tuning, and production support skills across application and cloud environments Excellent communication skills and the ability to collaborate effectively across engineering and non-engineering stakeholders. Medical insurance through Wellmark Blue Cross Blue Shield - choice of $2,000 PPO or High Deductible Health Plan (HDHP) Employee-only medical premium starting at $120/month Free Doctor on Demand virtual visits (covered at 100% on both plans) Dental insurance through Delta Dental of Iowa Vision insurance through Delta Vision Health Savings Account (HSA) - eligible with HDHP enrollment Flexible Spending Accounts (FSA) - Health Care, Limited Purpose, and Dependent Care options.
Senior Embedded Software Engineer Puck Enterprises Inc.Senior Embedded Software EngineerSDRequired Education & Experience: Bachelors degree in Computer Engineering, Electrical Engineering, Computer Science, Software Engineering, or a related technical field - or equivalent practical experience 6+ years of professional software engineering experience developing production-grade embedded systems Deep proficiency in C++ for embedded applications, including object-oriented design, multithreading, memory management, and performance-conscious development Strong hands-on experience developing software in an embedded Linux environment, including system bring-up, process-level debugging, and interaction with device interfaces Experience building UI or application components with Qt in embedded or industrial device environments Practical experience with industrial or vehicle communication protocols, including J1939 and CANBus or Ethernet, with strong understanding of message-based system integration and diagnostics Experience with Structured Text Language (ST) or comparable IEC 61131-3 programming used in control systems, PLC integration, or automation environments Experience with source control, automated testing, debugging tools, and modern software development practices in a team-based engineering environment Experience using AI-assisted development tools to improve software design, coding efficiency, testing, and debugging while maintaining code quality and sound technical judgment Strong debugging, performance tuning, and problem-solving skills across embedded software, device interfaces, and communication networks Excellent communication skills and the ability to collaborate effectively across software, hardware, systems, and non-engineering stakeholders. Medical insurance through Wellmark Blue Cross Blue Shield - choice of $2,000 PPO or High Deductible Health Plan (HDHP) Employee-only medical premium starting at $120/month Free Doctor on Demand virtual visits (covered at 100% on both plans) Dental insurance through Delta Dental of Iowa Vision insurance through Delta Vision Health Savings Account (HSA) - eligible with HDHP enrollment Flexible Spending Accounts (FSA) - Health Care, Limited Purpose, and Dependent Care options.
Application Security Engineer Ryder System IncApplication Security EngineerPierre, SDCompensation Information: The compensation offered to a candidate may be influenced by a variety of factors, including the candidate's relevant experience; education, including relevant degrees or certifications; work location; market data/ranges; internal equity; internal salary ranges; etc. Current Employees: If you are a current employee at Ryder, please click here ( http://wd5.myworkday.com/ryder/d/task/1422$3.htmld ) to log in to Workday to apply using the internal application process.
Staff Software Development Engineer CVS Health CorpStaff Software Development EngineerSD$106,605–$284,280 / yearFurthermore, the Staff Engineer role includes closely working with a team of engineers to drive delivery excellence, partner with business and other IT leaders to build digital assets, provide expert level support to resolve complex issues and provide RCA, identify gaps in systems in current digital eco system and provide solutions to enhance overall performance. CVS Health Digital is looking for hands-on, passionate people who want to join a high energy and growing team to make a difference in customers' lives and who want to be on the forefront of digital innovation that aims to reinvent what a pharmacy and a health care company can be in the digital world.
Medical Director - Radiation Oncology - MD or DO CVS Health CorpMedical Director - Radiation Oncology - MD or DOSD$174,070–$374,920 / yearThe Radiation Oncology Medical Director supports the CVS Health Specialty oncology business in managing oncology specific utilization of providers, clinical reviews of oncology specific data, and assist with growing our oncology footprint. In the Medical Director role, you will provide oversight for medical policy implementation; you will support the ensuring timely and consistent responses to members and providers; you will focus on prior authorization cases and consultation cases.
Data Conversion Lead MaximusData Conversion LeadSioux 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.
CRM Lead Engineer D.A. Davidson & Co.CRM Lead EngineerSD$95,000–$110,000 / yearSummary: We are looking for a Microsoft Dynamics 365 (CRM) Senior Software Engineer, experienced in designing and developing Microsoft-based business solutions in cloud environments using Dynamics 365 and Power Platform, to join our rapidly growing team. Highly desirable to have experience in Microsoft Azure Cloud solutions, including possessing a solid understanding of Microsoft Dataverse, Power Apps (Model-driven Apps, Canvas Apps, Power Pages), Power BI, Power Automate, and Data Factory.
Billing Operations Supervisor TAK Communications IncBilling Operations SupervisorSioux Falls, SD$53,000–$60,000 / yearThe Account Reconciliation Supervisor is responsible for supervising our Account Reconciliation team members, reconciling client statements for jobs completed by our technicians and resolving any discrepancies. This includes engineering teams, distributors, and more than 100 qualified construction crews with extensive experience across all ISP types and markets; over 300 experienced bury drop crews; and more than 700 professional technicians.