Investigator, Special Investigations Unit (Meritain Health) CVS Health CorpInvestigator, Special Investigations Unit (Meritain Health)SD$46,988–$122,400 / yearDemonstrated proficiency in Microsoft Office Suite (including Excel, specifically with pivot tables), database search tools, and use of the Intranet/Internet to research information. 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.
Surveillance Investigator Allied UniversalSurveillance InvestigatorSioux Falls, SDThe Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim. RESPONSIBILITIES: Conduct independent investigations of insurance claims across a range of coverage types, including workers' compensation, general liability, property and casualty, and disability.
Surveillance Investigator - Part Time Allied UniversalSurveillance Investigator - Part TimeRapid City, SDThe Surveillance Investigator will perform discreet mobile and stationary surveillance of a Claimant to confirm current activities and capabilities to assist with the administration of an insurance claim. RESPONSIBILITIES: Conduct independent investigations of insurance claims across a range of coverage types, including workers' compensation, general liability, property and casualty, and disability.
RCIS Crop Claims Field Adjuster II (SD Virtual) Zurich Insurance Group LtdRCIS Crop Claims Field Adjuster II (SD Virtual)SDRemoteAs a Crop Adjuster II, your primary responsibilities will include: With minimal supervision, completes field inspections and related responsibilities such as reading maps and aerial photos, measuring fields, storage bins, and discussing findings of crop loss with farmers on the most complex non-routine, problematic claims including controversial claims. RCIS offers a wide range of private product coverages, including a diverse selection of named-peril options, supplemental and stand-alone insurance products as well as federal crop insurance plans through the United States Department of Agriculture's Risk Management Agency.
Crop Claims Adjuster (South Dakota) Great American Insurance CompanyCrop Claims Adjuster (South Dakota)SDRemote$50,000–$65,000 / yearThe Division is also one of a select few private companies authorized by the United States Department of Agriculture Risk Management Agency (USDA RMA) to write MPCI policies. Conveys routine to moderately complex information regarding coverage and settlements to insureds, claimants, and external partners.
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 Claims Specialist State of South DakotaMedical Claims SpecialistPierre, 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.
NewLong Term Care Claims Representative - Payment Servicing Genworth Financial IncLong Term Care Claims Representative - Payment ServicingSD$45,500–$66,000 / yearYou will work in a fast -paced environment across multiple products, ensuring claims handling follows policy provisions, internal guidelines, and Compliance requirements and will be responsible for the processing and payment of long-term care claims. Your experience or education has provided you with knowledge of medical terminology, diseases/diagnoses, and the ability to understand and interpret contract language, disability processes, nursing home licensing, and rehabilitative requirements.
Claims Representative, Auto | Property Damage Sedgwick Claims Management Services, Inc.Claims Representative, Auto | Property DamageSD$50,000–$55,000 / yearProcesses auto property damage and lower level injury claims; assesses damage, makes payments, and ensures claim files are properly documented and correctly coded based on the policy. Sedgwick is building a diverse, equitable, and inclusive workplace and recognizes that each person possesses a unique combination of skills, knowledge, and experience.
NewCommunication Effectiveness Trainer - Allstate Claims University Allstate Insurance CompanyCommunication Effectiveness Trainer - Allstate Claims UniversitySD$62,100–$105,300 / yearCoaching, Coaching, Coaching Techniques, Collaboration, Collaborative Development, Communication, Communication Strategy Development, Cultural Awareness, Design, Development Communication, Empathic Communication, Facilitating Learning, Facilitation, Indian Culture, Instructional Design, Leadership, Learning and Development (L&D), Learning Effectiveness, Learning Materials Development, Negotiation, Objection Handling, Performance Management (PM), Project Coordination, Project Planning, Results-Oriented {+ 7 more}. Develops, designs and delivers learning offerings that are aligned to business and enterprise strategy; Ensures talent management practices are understood and supported consistently within learning offerings; Drive adoption of skills-based culture to empower and develop meaningful business-relevant skills through design and delivery of learning.
NewInstructional Designers - Allstate Claims University Allstate Insurance CompanyInstructional Designers - Allstate Claims UniversitySD$53,500–$86,400 / yearAdult Development, Adult Learning Methodologies, Adult Training, Auto Insurance Claims, Bodily Injury Claims, Communication, Content Design, Development Strategy, Facilitate Training Sessions, Facilitating Adult Learning, Facilitating Learning, Facilitation, Injury Assessment, Instructional Design, Learning and Development (L&D), Learning Effectiveness, Learning Materials Development, Learning Systems, Personal Injury Claims, Project Coordination, Training Facilitation, Training Programs. Builds and maintains relationships with business partners, clients and cross-functional teams; Drive adoption of skills-based culture to empower and develop meaningful business-relevant skills through design and delivery of learning.
Virtual Life Insurance Agent - Remote InsuraTecVirtual Life Insurance Agent - RemoteSioux Falls, SDRemoteLife Insurance Sales, Remote Sales, Final Expense, Mortgage Protection, Work from Home, Insurance Agent, Sales Closer, Entry Level Sales, Commission Sales, Licensed Insurance Agent, Virtual Sales, High Commission. We’re hiring Remote Life Insurance Agents who want to close high-quality leads, earn uncapped commission , and build a long-term career — all from home.
Patient Care & Insurance Coordinator Covenant DentalPatient Care & Insurance CoordinatorSioux Falls, SD$22–$30 / hourThey possess strong knowledge of dental insurance, confidently communicate with patients and insurance companies, proactively solve problems, and understand that outstanding customer service is just as important as clinical excellence. Dr. Troy Keyes and Dr. Carley Odens have more than 30 years of combined experience providing exceptional dental care and building lasting relationships with patients throughout our community.
NewInsurance/Billing Coordinator Visions Eye CareInsurance/Billing CoordinatorSioux Falls, SDWhy you'll love working with us: At Visions Eye Care + Therapy Center, we value our employees and strive to create a positive and supportive work environment. Visions Eye Care + Therapy Center is seeking a detail-oriented and organized Insurance/Billing Coordinator to join our team in Sioux Falls, SD.
Aflac Insurance Agent AFLAC - Eastern Central Regional SDAflac Insurance AgentHuron, SD$45,000–$75,000 / yearAs an Aflac insurance benefits advisor, you’ll guide clients through important decisions, help deliver outstanding service and build strong, lasting relationships all while earning a rewarding income and growing with a trusted brand. Present and communicate the value of Aflac’s solutions to employers and employees, helping them make informed benefit decisions.
Insurance Agent - Rapid City, SD American Family Insurance GroupInsurance Agent - Rapid City, SDRapid City, SDFrom our CEO to our agency force, we're committed to growing a diverse and inclusive culture that empowers innovation that will inspire, protect, and restore our customers' dreams in ways never imagined. At American Family, we're seeking highly motivated individuals with a demonstrated track record of success and eagerness to accomplish something that takes time, energy, and commitment.
Field Site Inspector - Part Time Allied UniversalField Site Inspector - Part TimeRapid City, South Dakota$23–$28 / hourKnowledge of Regulations: Familiarity with industry regulations, such as those from the National Committee for Quality Assurance (NCQA) and The Joint Commission (TJC), Medicare Provider Enrollment, or other healthcare profession or facility credentialing, is highly preferred. The Field Site Inspector will perform site visit inspection services for Medicare and Medicaid providers/suppliers in accordance with established requirements.
Bodily Injury Litigation Adjuster (Homeowner Liability) Allstate Insurance CompanyBodily Injury Litigation Adjuster (Homeowner Liability)Pierre, SD$56,000–$82,500 / yearAutomobile Accidents, Automobile Accidents, Case Management, Casualty Insurance, Claims Administration, Claims Litigation, Claims Resolution, Claims Review, Commercial General Liability Insurance, Commercial Liability, Complex Claims, Fractures, General Liability Claims, General Liability Insurance, Homeowners Claims, Homeowners Insurance, Homeowners Insurance Claims, Insurance Claim Handling, Insurance Litigation, Insurance Policies, Liability Insurance, Litigation, Litigation Management, Litigation Support, Negotiation {+ 2 more}. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.
Bodily Injury Large Loss Adjuster Allstate Insurance CompanyBodily Injury Large Loss AdjusterSD$85,000–$145,075 / yearBodily Injury Claims, Claims Litigation, Client Counseling, Complex Claims, Conflict Management, De-Escalation, Diary Management, Documentations, File Reviews, Industry Trend Analysis, Insurance Claims Investigations, Large Loss Claims, Liability Analysis, Liability Investigations, Litigation, Negotiation, Personal Injury Claims, Prioritization, Torts. Works with Product, Protection, Law, and Claims on new products introduced to the Field and the sales force, and develops Claim Bulletins to provide new forms and/or endorsements that impact claim handling practices.
NEST Supplement Appraiser Allstate Insurance CompanyNEST Supplement AppraiserSDRemote$28.03–$42.99 / hourThe NEST Supplement Appraiser is a fully remote work at home position responsible for handling supplemental repair estimates with non-network repair facilities while ensuring accurate damage assessments, timely claim resolution, and exceptional customer service. Through our subsidiaries, we provide a variety of insurance products, including personal and commercial automobile, homeowners, umbrella, recreational vehicle, supplemental health, lender-placed and other niche insurance products.
Customer Service Representative - State Farm Agent Team Member Ty Teveldal - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberSioux Falls, SDAs a Customer Service Representative - State Farm Agent Team Member with Ty Teveldal - State Farm Agent, you will generate the kind of exceptional client experiences that reinforce the growth of a successful insurance agency. You will enhance your career while resolving customer inquiries, coordinating with other agency team members, and anticipating the needs of the community members you support.
Program 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.
Patient Billing Representative Five Star SolutionsPatient Billing RepresentativeRapid City, South DakotaRemoteJoin us as a Patient Billing Specialist, where you’ll support patients with payment processing, billing education, insurance verification, and claims-related inquiries. Educate patients on billing concepts including coordination of benefits, deductibles, coinsurance, copays, timely filing, and claim denials.
Account Associate - State Farm Agent Team Member Ty Teveldal - State Farm AgentAccount Associate - State Farm Agent Team MemberSioux Falls, SDROLE DESCRIPTION: As Account Associate - State Farm Agent Team Member for Ty Teveldal - State Farm Agent, you are vital to our daily business operations and customers’ success. You grow our agency through meaningful client relations and acting as a liaison between customer needs and agency departments.
Pharmacy Tech Sam''''''''s- PT Walmart IncPharmacy Tech Sam''''''''s- PTSioux Falls, SD$19–$27 / hourRespect the Individual: Embraces differences in people cultures ideas and experiences creates a workplace where associates feel seen supported and connected through a culture of belonging creates opportunities for all associates to thrive and perform helps to attract the best talent. Serve our Customers and Members Makes decisions based reliable information balances short and longterm priorities and considers how own work impacts the teams ability to deliver on our purpose for all stakeholders.
NewPharmacy Tech Sam''''''''s Walmart IncPharmacy Tech Sam''''''''sRAPID CITY, SD$18.50–$26.50 / hourRespect the Individual: Embraces differences in people cultures ideas and experiences creates a workplace where associates feel seen supported and connected through a culture of belonging creates opportunities for all associates to thrive and perform helps to attract the best talent. Serve our Customers and Members Makes decisions based reliable information balances short and longterm priorities and considers how own work impacts the teams ability to deliver on our purpose for all stakeholders.
Special Agent U.S. Department of Homeland SecuritySpecial AgentSD$48,854–$118,204 / yearYou are minimally qualified for the GL-07 Level starting base salary 48854 if you possess one of the following: A bachelors degree from an accredited college or university with Superior Academic Achievement (S.A.A.), which is based on: Class standing: Applicants must be in the upper third of the graduating class in the college, university, or major subdivision (such as the College of Liberal Arts or the School of Business Administration) based on completed courses. Grade-point average (G.P.A.): Applicants must have a grade-point average of 3.0 or higher out of a possible 4.0 (B or better) as recorded on their official transcript or as computed based on 4 years of education or as computed based on courses completed during the final 2 years of the curriculum.
Records & Project Coordinator SERVPRO of West Sioux FallsRecords & Project CoordinatorHartford, SDSERVPRO Franchise employees are not employed by, jointly employed by, agents of or under the supervision or control of SERVPRO Industries, LLC or SERVPRO Franchisor, LLC (the Franchisor), in any manner whatsoever. If you take pride in quality work, can juggle multiple tasks without breaking a sweat, and love working in a fast-paced environment where accuracy actually matters, you might just thrive here.
Account Associate - State Farm Agent Team Member Tyler Baker - State Farm AgentAccount Associate - State Farm Agent Team MemberSioux Falls, SDROLE DESCRIPTION: As a account associate for Tyler Baker State Farm, you are vital to our daily business operations and customers’ success. You grow our agency through meaningful customer relations and acting as a liaison between customer needs and agency departments.
Customer Service Representative - State Farm Agent Team Member Jan Scriver - State Farm AgentCustomer Service Representative - State Farm Agent Team MemberMilbank, SDAs a customer service with Scriver Insurance & Financial Services, you will generate the kind of exceptional customer experiences that reinforce the growth of a successful insurance agency. You will enhance your career while resolving customer inquiries, coordinating with other agency team members, and anticipating the needs of the community members you support.
Order Specialist | Home Plus Monument Health Rapid City HospitalOrder Specialist | Home PlusRapid City, South DakotaDemonstrates knowledge of third-party payer information, including Medicare, Medicaid, VA, Tricare/UHC and commercial payers, to ensure compliance with rules and regulations to maintain accurate reimbursement. Current Employees: If you are a current Monument Health employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.