Sanford Health

Insurance

• Verify patient demographics and enter accurate patient information.
• Identify appropriate third-party insurance payers and verify insurance coverage.
• Set up insurance and create or update patient accounts for billing.
• Initiate patient financial assistance and contact insured or financially responsible parties to obtain missing information and verify.
• Select appropriate insurance payers for billing and assure accounts are set up correctly and timely.
• Document all contacts and account activity in the computer system.
• Identify and promptly resolve billing complaints or escalate to supervisor when unable to resolve.
• Consistently input data accurately and utilize software applications for maximum efficiency.
• Complete work within authorized time and work accounts throughout the entire revenue cycle for efficiency.

Associate Insurance Representative

SEO Marketing

• Plan, implement and manage the organization’s overall SEM strategy.
• Partner with media strategists to deploy search marketing tactics to increase online visibility and engagement.
• Analyze research, data or technology to understand user intent and uncover optimization opportunities.
• Utilize SEO data to assist optimization of SEM and PPC campaigns to minimize CPC and increase CTR.
• Partner with marketing analytics team to use site traffic data to inform paid search performance decisions.
• Manage PPC campaigns across Search Ads 360, Google and Bing.
• Work with web and content teams to drive quality traffic, increase conversions and maximize ROI.
• Perform ongoing paid keyword discovery, expansion and optimization.
• Research and analyze competitor advertising keywords and links.
• Identify KPIs and report key metrics; coordinate reporting dashboards and present to stakeholders.
• Improve search-related activities through analysis, experimentation or A/B testing.

Search Engine Marketing Specialist

Analyst

• Strategically leads the reimbursement team in analyzing and implementing new payment methodologies to establish optimal reimbursement and payment levels.
• Creates policies and procedures for reimbursement functions including estimating, modeling and reporting provider reimbursement/payment levels.
• Coaches others in the organization regarding reimbursement functions and third party payor issues.
• Directs implementation and monitoring of reimbursement functions including Medicare, Medicaid, cost reports, audits, appeals, DSH programs, 340B and CPT/HCPCS code changes.
• Leads review and impact analysis of payor proposed and final Medicare and Medicaid regulation changes.
• Reviews and provides expertise on payor contract changes during negotiations and finalizations; consults on third party payor contracts in Experian and Contract Maintenance.
• Directs reports for annual pricing and fee schedule updates, including impacts on physician compensation.
• Consults in annual budgeting and audit processes (monthly discounts, year-end discounts, third party reserves).
• Supports operations and CDM team in maintaining charge masters and setting up new codes and prices; assists with enterprise pricing initiatives.
• Produces reports, analyzes and integrates data; develops, summarizes, presents and explains data.
• Promotes integrity and confidentiality of data; develops and updates policies and procedures when directed.
• Develops and maintains relationships with finance and accounting staff across the enterprise and provides coaching and reimbursement support.

Lead Reimbursement Analyst

Events

• Collaborates with regional infection control teams to align and standardize work and maintain the research, development, and deployment of infection prevention and control strategies across the enterprise.
• Leads complex, system wide projects to optimize processes.
• Serves as point of contact, subject matter expert, and central source of communication regarding infection control.
• Leads enterprise initiatives focused on the prevention of healthcare associated infections.
• Collaborate with stakeholders and engage leadership and staff at the regional markets to encourage participation in relevant infection prevention initiatives.
• Works closely with leadership to establish best practices based on industry standards and published guidelines.
• Orchestrate and influence the work of others to enhance Sanford's mission and vision and to achieve evidence-based clinical practices that focus on the infection prevention and control throughout the Sanford enterprise.
• Creates a vision for enterprise Infection Prevention and Control that is consistent with the ongoing needs and growth of the integrated health system.
• Identify opportunities to improve outcomes and communicate findings to appropriate leadership.
• Inform leaders within each market to develop strategies to reach top performance.
• Accountable to develop programmatic planning and project management to achieve the strategic goals of Sanford pertaining to Infection Prevention and Control.
• Knowledgeable of nursing and medical practices and procedures, as well as laws, regulations, and guidelines that pertain to infection prevention and control.
• Extensive knowledge of epidemiology, microbiology, infectious disease, and principles of asepsis, disinfection, and sterilization.
• Ability to apply principles of epidemiology to conduct infection surveillance so as to identify, analyze, recommend, and evaluate quality improvement measures to ensure successful programs.
• Able to apply knowledge of acute care practices relevant to infection prevention and control and epidemiology to small rural acute care settings, non-traditional health care settings, such as long-term care, home health, hospice, correctional facilities, clinics, outpatient settings, and ambulatory surgery centers.
• Possesses the ability to plan, organize, develop, implement and interpret the programs, goals, objectives, policies, and procedures that are necessary for a comprehensive Infection Prevention and Control program.
• Willing to seek out new methods and principles and be willing to incorporate them into existing practices.
• Ability to work with growth and development needs of unique client population.
• Possesses the ability to deal effectively with personnel, patents, family members, visitors, clients, regulatory agencies/personnel and the public.
• Possesses leadership ability and maintain the willingness to work harmoniously with professional and non-professional personnel.
• Requires a self-motivated individual who values patient and staff safety as the top organizational priority.
• Knowledge and/or an interest in safe systems and High Reliability Organizations necessary.
• Must have a passion for patient and staff safety.
• Bachelor’s degree in related field is required.

Infection Prevention Strategist

Community Manager

• Schedules nursing staff to specific shifts, taking into account past utilization trends.
• Measures employee performance.
• Assists in the training of new staff members and the development of existing staff members.
• Manages workflow volumes, including monitoring and processing of work queues.
• Applies key aspects of continuous improvement processes and evaluates impact on quality.
• Monitors patient/resident care areas and other facilities for cleanliness and readiness.
• Provides nursing care to patients/residents on an as needed basis.
• Opportunities to assist and manage special projects as assigned by leadership, championing enterprise scope and initiatives.
• Directs nurse and other staff activities for patients/residents receiving home health and/or hospice services in the assigned service area.
• Ensures effectiveness and efficiency of home health and/or hospice services.
• Delegates responsibilities to clinical and professional staff within home care and/or hospice.
• Provides direction on nursing practice and home care and/or hospice regulations to staff.
• Provides input for planning and budgeting.
• Coordinates inter-disciplinary communication and collaboration among team members.
• Works in collaboration with the communities we serve and is an internal liaison and to outside agencies.

Clinical Manager, Home and Community Based Services - Full Time Day

Artificial Intelligence

• Monitor and maintain the process of gathering current, accurate, and complete information for provider directories and payor databases in compliance with regulations and payor requirements.
• Follow up with payors to obtain effective dates, status updates, and identification numbers for billing purposes.
• Update and maintain provider numbers and related data in both internal and external billing software and production programs.
• Maintain supporting documentation such as a W-9, CLIA certificate, bank, IRS, and CMS letters as applicable.
• Apply for or provide assistance with the application process for individual practitioner and/or facility national provider identifier (NPI) via national plan and provider enumeration system (NPPES).
• Notify payors and internal contacts of practitioner practice changes, including terminations, cases of malpractice, or other legal matters.
• Also will notify payors of site notification for payors (i.e., for new sites, site terminations, and changes).
• Perform account follow up on enrollment related denials and take the necessary action for account resolution in accordance with established federal and state regulations.
• Respond to internal and external inquiries regarding research issues.
• Review charges and claims pending report and/or claim edit work queues in Epic.
• May work Epic follow-up work queues to resolve enrollment-related issues.
• Keep current regarding any changes in managed care and other payor requirements for provider enrollment.
• Complete work within authorized time to assure compliance with strict departmental and compliance standards as well as payor time limits.
• Initiate enrollment for electronic claims submission.
• Attend site-planning meetings to provide input, gather necessary information for set up, and provide updates.

Associate Insurance Representative

Search Engine Marketing Specialist

Lead Reimbursement Analyst

Infection Prevention Strategist

Lead Reimbursement Analyst

Clinical Manager, Home and Community Based Services - Full Time Day

Provider Enrollment Representative - Remote IA, MN, ND, SD