Claims Processing Manager jobs in Pierre, SD

Claims Processing Manager manages the administration of health insurance claims, payment processing, billing research, and responding to inquiries. Ensures timely and proper disposition of claims in accordance with coverage amounts. Being a Claims Processing Manager trains staff on organizational policies and ensures procedures are followed at all times. Provides guidance on more complex or high-value claims. Additionally, Claims Processing Manager typically requires a bachelor's degree. Typically reports to a head of a unit/department. The Claims Processing Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. To be a Claims Processing Manager typically requires 5 years experience in the related area as an individual contributor. 1 - 3 years supervisory experience may be required. Extensive knowledge of the function and department processes. (Copyright 2024 Salary.com)

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Claims, Advice, and Processing Specialist
  • South Dakota State Government
  • Pierre, SD FULL_TIME
  • Job ID: 26866
    Agency: Department of Social Services / Division of Medical Services
    Location: Pierre
    Salary: $18.25 per hour
    Pay Grade: GH
    Closing Date: 05.09.2024

    This is a Full-Time 40 Hour Weekly position with the Department of Social Services Division of Medical Services. For more information on the DSS, please visit https://dss.sd.gov.

    Summary:
    This position is responsible for assisting medical providers and recipients with their Medicaid claims. Duties include responding to calls from Medicaid providers and recipients to identify and resolve issues related to submitted claims. In addition, this position identifies and resolves errors on Medicaid claims that have been submitted.

    The Ideal Candidate Will Have:
    Experience in customer service position and processing medical claims.

    Knowledge, Skills, Abilities:

    • mathematical calculation methods;
    • medical billing and coding knowledge (preferred but not required, will train);
    • claims processing practices and procedures (preferred but not required, will train);
    • demonstrate customer service, compassion, respect, courtesy and tact when interacting with others;
    • communicate information clearly and concisely, including obtaining and providing information by phone in a courteous manner;
    • plan and organize work to meet schedules and deadlines and respond and adjust to multiple demands;
    • take steps to effective resolve problems in conflict situations.

    This position is eligible for Veterans’ Preference per ARSD 55:10:02:08.

    NCRC: If you possess a National Career Readiness Certificate, please submit the certificate with your application. For more information on how to acquire a National Career Readiness Certificate contact a South Dakota Department of Labor and Regulation Job Service Office. A certificate is not necessary to be considered.

    The State of South Dakota does not sponsor work visas for new or existing employees. All persons hired will be required to verify identity and eligibility to work in the United States and complete an Employment Eligibility Verification, Form I-9. The State of South Dakota as an employer will be using E-Verify to complete employment eligibility verification upon hire.

    The State of South Dakota offers employer paid health insurance plus eleven paid holidays, generous vacation and sick leave accrual, dental, vision, and other insurance options, and retirement benefits. You can view our benefits information at https://bhr.sd.gov/job-seekers/work-for-state-government/. This position is a member of Class A retirement under SDRS.

    Must apply online: https://sodakprod-lm01.cloud.infor.com:1443/lmghr/xmlhttp/shorturl.do?key=PKX
    You must apply online, emailed resumes or submissions will not be accepted.
    South Dakota Bureau of Human Resources
    Telephone: 605.773.3148 Email: careers@state.sd.us
    http://bhr.sd.gov/workforus
    "An Equal Opportunity Employer"




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  • 2 Days Ago

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Independent Insurance Claims Adjuster in Pierre, South Dakota
  • MileHigh Adjusters Houston Inc
  • Pierre, SD FULL_TIME
  • Exciting Opportunity for Aspiring Claims Adjusters! INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW!Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjus...
  • 4 Days Ago

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Independent Insurance Claims Adjuster in Aberdeen, South Dakota
  • MileHigh Adjusters Houston Inc
  • Aberdeen, SD FULL_TIME
  • Exciting Opportunity for Aspiring Claims Adjusters! INDEPENDENT INSURANCE CLAIMS ADJUSTERS NEEDED NOW!Are you ready to embark on a dynamic and in-demand career as an Independent Insurance Claims Adjus...
  • 4 Days Ago

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Manager Trainee
  • Menard, Inc Career Center
  • ABERDEEN, SD FULL_TIME
  • Make BIG Money at Menards! Extra $3 per hour on Sat/Sun Store Discount Profit Sharing Exclusive Discounts for gyms, car dealerships, cell phone plans, and more! Flexible Scheduling Medical Insurance a...
  • Just Posted

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Store Manager
  • Hibbett | City Gear
  • Pierre, SD FULL_TIME
  • 01217 Pierre, SD LE_301 Hibbett Retail, Inc.Job Title: Store Manager Department: Operations FLSA Status: Non-Exempt Reports To: District Sales Manager SUMMARYThe Store Manager oversees and is responsi...
  • 22 Days Ago

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Assistant Manager
  • Qdoba Restaurants and Modern Market Eatery
  • Aberdeen, SD FULL_TIME
  • Assistant Restaurant Manager Job Description If you're a positive, burrito-loving, high performer and a born leader, then we want to talk to you! As the Assistant Restaurant Manager, you'll enjoy the ...
  • 22 Days Ago

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0 Claims Processing Manager jobs found in Pierre, SD area

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Store Manager
  • Riddle's Group
  • Pierre, SD
  • Job Description Job Description Exciting Opportunity Alert! Riddle’s Jewelry is on the hunt for a dynamic Management Lev...
  • 5/1/2024 12:00:00 AM

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Vice President, Infrastructure Operational Reliability & Resilience
  • Marriott
  • Pierre, SD
  • Job Number 24050780 Job Category Information Technology Location Marriott International HQ, 7750 Wisconsin Avenue, Bethe...
  • 5/1/2024 12:00:00 AM

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Vice President, Infrastructure Operational Reliability & Resilience
  • Careerbuilder
  • Pierre, SD
  • Location field must contain 'city, state' or a zip code to perform a radius search (e.g., Denver, CO or 46122 ). City an...
  • 5/1/2024 12:00:00 AM

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Business Operations Manager
  • Confluent
  • Pierre, SD
  • Confluent is pioneering a fundamentally new category of data infrastructure focused on data in motion. Have you ever fou...
  • 4/30/2024 12:00:00 AM

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SR Project Manager
  • Lumen
  • Pierre, SD
  • About Lumen Lumen connects the world. We are igniting business growth by connecting people, data and applications - quic...
  • 4/30/2024 12:00:00 AM

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Operations Manager, Launch - East
  • WelbeHealth
  • Pierre, SD
  • WelbeHealth provides high-quality healthcare and social care services to vulnerable seniors in local communities in our ...
  • 4/29/2024 12:00:00 AM

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EPMO Senior Project Manager I
  • Amentum
  • Pierre, SD
  • We are seeking an accomplished and dynamic professional to join our organization as a Senior Project Manager level 1 (Sr...
  • 4/29/2024 12:00:00 AM

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Project Manager
  • American Express Global Business Travel
  • Pierre, SD
  • Amex GBT is a place where colleagues find inspiration in travel as a force for good and through their work can make an i...
  • 4/29/2024 12:00:00 AM

Pierre (/pɪər/; Lakota: čhúŋkaške, "fort") is the capital of the U.S. state of South Dakota and the seat of Hughes County. The population was 13,646 at the 2010 census, making it the second-least populous state capital in the United States, following only Montpelier, Vermont, and the eighth-most populous city in South Dakota. Founded in 1880 on the east bank of the Missouri River opposite Fort Pierre, Pierre has been the state capital since South Dakota gained statehood on November 2, 1889. It was challenged by Huron for the capital and won because of its location in the geographic center of t...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Claims Processing Manager jobs
$80,182 to $103,561
Pierre, South Dakota area prices
were up 0.8% from a year ago

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Managers can review workflow queues and see what is in each processor’s queue.
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A common duty in this position is reviewing insurance policies after clients have submitted claims, in order to determine coverage.
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