Avera Health

Title: Registered Nurse (RN) Clinical Reimbursement Specialist | Long-term care Full time Location: Avera at Home Sioux Falls Worker Type: Regular Work Shift: Day Shift (United States of America) Pay Range: The pay range for this position is listed below. Actual pay rate dependent upon experience. $78,000.00 - $116,480.00 Position Highlights Hybrid position with some travel involved Job Description: You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview Responsible for ensuring accurate clinical documentation, assessment and Minimum Data Set ("MDS") coding to support appropriate reimbursement. This role blends strong clinical expertise with regulatory knowledge and analytical skills. This role will oversee compliance, accuracy and optimization of clinical reimbursement strategies for the LTC Division as well as clinical reimbursement compliance and overarching MDS support to teams across Avera. What you will do - Maintains knowledge of federal regulations, practice standards, and procedures, as well as guidelines pertaining to the RAI process. Develop division strategies for maximizing reimbursement for PDPM, Managed Care and other payer models. - Utilizes clinical judgement and nursing process to be a resource for Nurse Assessment Coordinators, Interdisciplinary team members and LTC Leaders. Develops strategies for maximizing reimbursement under PDPM, Managed Care and other payer models. - Partners with payor contracting on Managed Care/ACO contract utilization and ensures facilities adhere to payer guidelines, timely filing requirements, and pre-authorization processes. - Audits and implements action plans to improve staff education/competency as needed to ensure accurate and timely completion of supporting documentation and MDS assessment. - Monitors facility schedules for timely and complete MDS data submission as per Federal, State, and other payor requirements. - Analyzes reimbursement trends, identify deviations, implement corrective action plans through utilization of system data and analytic resources. - Acts as a liaison between facilities, finance, MDS, nursing, and system resources to ensure accurate reimbursement levels. - Provides ongoing operational support and guidance to facilities regarding denial management, appeals, and reimbursement strategies. - Leads the division efforts to implement best practices for accurate capture of the data elements of the Minimum Data Set (MDS), which is the key driver of the care plan, quality measures and reimbursement programs. - Must be willing to travel. Essential Qualifications The individual must be able to work the hours specified. 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. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer. Required Education, License/Certification, or Work Experience: - Registered Nurse (RN) - Board of Nursing An active license in the state of practice Upon Hire and - Resident Assessment Coordinator - Certified (RAC-CT) - American Association of Post-Acute Care Nursing (AAPACN) An active certification by AAPACN or another approved certification agency to ensure knowledge of clinical assessment and care planning, completion of the MDS, and the regulatory body surrounding the RAI/MDS process within 180 Days - Strong leadership and communication skills with the ability to train and mentor teams Preferred Education, License/Certification, or Work Experience: - Bachelor's - Extensive knowledge of Medicare, Medicaid, PDPM, Managed Care, QM, and CMI reimbursement systems - Strong expertise in MDS processes, including completion, regulatory compliance - Regional MDS experience - Proficiency in analyzing reimbursement trends, auditing, and implementing performance improvements Expectations and Standards - Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community. - Promote Avera’s values of compassion, hospitality, and stewardship. - Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity. - Maintain confidentiality. - Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment. - Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable. Benefits You Need & Then Some Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future. - PTO available day 1 for eligible hires. - Up to 5% employer matching contribution for retirement - Career development guided by hands-on training and mentorship

Location: Avera McKennan Hospital Worker Type: Regular Work Shift: Day Shift (United States of America) Pay Range: The pay range for this position is listed below. Actual pay rate dependent upon experience. $19.50 - $31.50 Position Highlights A Brief Overview The Centralized Scheduler is responsible for responding to outpatient diagnostic orders from physicians for hospital departments; interpret physician request for diagnostic test and schedule single to multiple tests according to required patient care protocols. This position requites the ability to determine medical necessity validation and handle medical information along with transpiring medical orders into the health information system. Required Education, License/Certification, or Work Experience: - Associate's Science in Medical Assisting from an accredited university/college and/or 3-5 years hospital, medical office, clinic, or hospital business operations experience Preferred Education, License/Certification, or Work Experience: - 4-6 years hospital, medical office, clinic, hospital business operations and/or Admitting Department experience Varied Shifts, Monday-Friday, 7:00am-5:00pm; 72hrs/2wks **This position can be remote after 6-8 months of in-house orientation completion and/or longer up to Supervisor** ***MUST Live within 150 miles from Sioux Falls, SD*** You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview Responsible to accept and coordinate the intake of patients and physician orders. Interprets requests from physician orders and coordinates scheduling for patients. Provides timely, accurate information to patients/caregivers, healthcare staff and providers. What you will do - Ensures the timely and accurate intake and scheduling of patients by gathering and disseminating necessary information. - Communicates with patients, family, physicians and staff as needed to obtain necessary orders and to coordinate the patient’s scheduled visits. - Provides patient explanation and education as necessary to respond to patient questions. - Performs audits as requested by the manager. - Completes timely and accurate clinical documentation. - Assists with initial and subsequent insurance authorizations when needed. Essential Qualifications The individual must be able to work the hours specified. 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. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer. Required Education, License/Certification, or Work Experience: - Licensed Practical Nurse (LPN) - Board of Nursing An active license in the state of practice Upon Hire - 1-3 years healthcare experience Expectations and Standards - Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community. - Promote Avera’s values of compassion, hospitality, and stewardship. - Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity. - Maintain confidentiality. - Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment. - Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable. Benefits You Need & Then Some Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future. - PTO available day 1 for eligible hires. - Up to 5% employer matching contribution for retirement - Career development guided by hands-on training and mentorship Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org.

Location: Avera Health Broadband Lane Worker Type: Regular Work Shift: Primarily days with night, weekend and holiday on-call involvement (United States of America) Position Highlights - 7-10 Years of Multi-site experience preferred - Strong understanding of HME/DME products, billing, coding and compliance -must have - Proven ability to lead teams, improve process and manage financial performance - required - Required travel within the Region of responsibility and home office - Required - Must live within the Region - Required You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview The Regional Director of HME/Durable Medical Equipment (DME), Operations oversees the strategic, financial, and clinical performance of multiple HME locations or branches within a specific region. The Regional Director ensures regulatory compliance (e.g., CMS, accreditation), manage budgeting, drive revenue growth, and lead staff to maintain high-quality patient care and operational efficiency. What you will do - Operational Leadership: Directs daily activities across multiple sites to ensure high-quality, efficient service and adherence to company policies and procedures. - Compliance & Safety: Ensures strict adherence to DMEPOS standards, accreditation bodies, OSHA, FDA, DOT, and federal/state, and local regulations. - Financial Management: Manages regional budgets, reviews monthly financial statements, controls operating expenses, and drives revenue growth. - Talent Management: Mentors and supervises branch managers, conducts performance evaluations, and develops staff skills. - Logistics & Inventory: Oversees inventory control, supply chain efficiency, and equipment delivery processes. - Oversee quality assurance/audit programs and conduct ongoing and periodic performance assessments to ensure quality standards are being met at their local branches. - Collaborates with leaders, peers, and team members to support the development and implementation of safety programs at the community and regional level. - Partners with Provider Referrals, Access Services, Patient Financial Services, Advanced Respiratory Services, Branch Manager’s and the Sales team to ensure timely equipment setup, proper documentation for the setup, and documentation for billing within 30 days. - Assists with sales and rentals of equipment, set-up, and education to customers, training of staff and referral sources, documentation, reimbursement verification, follow-up, and any related duties as required. - Responsibilities include interviewing, hiring, developing, training, and retaining employees; planning, assigning, and leading work; appraising performance; rewarding and coaching employees; addressing complaints and resolving problems. Essential Qualifications The individual must be able to work the hours specified. 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. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer. Required Education, License/Certification, or Work Experience: - Bachelor's Business, Marketing, Health Administration or related field or equivalent industry experience - Drivers License - Licensing Board Upon Hire - Strong understanding of DME billing, coding, and compliance. - Leadership: Proven capability to lead teams, improve processes, and manage financial performance. - Travel: Regular, high-volume travel within the assigned region. Preferred Education, License/Certification, or Work Experience: - 7-9 years in medical/DME operations, with significant multi-site management experience. Expectations and Standards - Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community. - Promote Avera’s values of compassion, hospitality, and stewardship. - Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity. - Maintain confidentiality. - Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment. - Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable. Benefits You Need & Then Some Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future. - PTO available day 1 for eligible hires. - Up to 5% employer matching contribution for retirement - Career development guided by hands-on training and mentorship Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org.

Location: Avera McKennan Hospital Worker Type: Regular Work Shift: Day Shift (United States of America) Pay Range: The pay range for this position is listed below. Actual pay rate dependent upon experience. $22.75 - $32.75 Position Highlights You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview Responsible for reviewing retail prescriptions that qualified for the hospital's 340B Drug Pricing Contract Pharmacy Program. This role is required to review all eligible prescriptions and check eligibility against the hospital's electronic medical record for appropriate matching documentation and make corrections within the pharmacy's reprocessing window and provide regular feedback to the leadership of Pharmacy Business & Analytics on auditing trends. What you will do - Review, analyze and determine eligibility of contract pharmacy claims by investigating patient records in hospital EMR to ensure each prescription meets the 340B patient definition. - Reverse ineligible claims within pharmacy reprocessing window. - Communicate audit results with the Pharmacy Business & Analytics Team, External 340B Software Vendor, Contract Pharmacies, Avera 340B Steering Committee and Avera Corporate Compliance Committee. - Document all requested reversals and ensure reversals occur Maintain accurate provider file for hospital's assigned to. - Remain current with 340B patient definition and current federal auditing guidelines and best practices. - Monitor and report trending of third party contract pharmacy audits to Director of Pharmacy Business & Analytics, Avera 340B Steering Committee and Avera Corporate Compliance Committee. Essential Qualifications The individual must be able to work the hours specified. 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. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer. Required Education, License/Certification, or Work Experience: - Associate's or certified pharmacy technician. or - Certified Pharmacy Technician (CPhT) - Pharmacy Technician Certification Board (PTCB) Certified as a pharmacy technician by the Pharmacy Technician Certification Board (PTCB) Upon Hire - 1-3 years experience within a hospital business office, medical related field, health plan, third party administrator, or managed care industry Expectations and Standards - Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community. - Promote Avera’s values of compassion, hospitality, and stewardship. - Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity. - Maintain confidentiality. - Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment. - Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable. Benefits You Need & Then Some Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future. - PTO available day 1 for eligible hires. - Up to 5% employer matching contribution for retirement - Career development guided by hands-on training and mentorship Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org.

Location: Avera Downtown Building-Sioux Falls Worker Type: Regular Work Shift: Primarily days with night, weekend and holiday on-call involvement (United States of America) Pay Range: The pay range for this position is listed below. Actual pay rate dependent upon experience. $67,080.00 - $100,880.00 Position Highlights Strong networking background Position dealing with mainly firewalls Communication Network Controls You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview Actively drives participation in the development, evaluation, and reporting of information technology security controls and risks mitigation strategies as well as security processes in the IT and business environments. Delivers and may assist other team members in risk identification and mitigation strategies and processes, control documentation, evaluation of control design, evaluation of control operation, reporting of control deficiencies, and remediation strategies. Reviews current processes for improvements in control documentation & testing for effectiveness and efficiency. What you will do - Actively drives team participation in establishment, evaluation, and reporting on risks and controls in the IT and business environments. - Designs, performs, and evaluates the current testing of controls while maintaining and improving the process for evaluation of IT controls through a combination of automated testing and interviewing. - Assists in management of the IT policy lifecycle including development of IT policy standards and IT policy review processes. - Identify and review current risk areas for IT; analyze existing policies for gaps in coverage for these areas. - Perform internal self-assessments for management. - Monitor IT policies to ensure compliance with all aspects of federal, state, and local laws and regulations. - Collects information on control failures/unmitigated risks, and remediation results to build compliance reports for IT and business management. - Provides advisory services for IT controls to projects, teams, and audits by ensuring consistent control implementation through documented processes for identifying control requirements prior to their implementation into production IT environments. Essential Qualifications The individual must be able to work the hours specified. 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. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer. Preferred Education, License/Certification, or Work Experience: - Bachelor's in related area - Certified Information Systems Auditor (CISA) - ISACA - Certified Information Systems Security Professional (CISSP) - International Information System Security Certification Consortium (ISC2) - Network+ - Computing Technology Industry Association (CompTIA) - Security+ - Computing Technology Industry Association (CompTIA) - 4-6 years Related experience in IT, project management, compliance or security areas Expectations and Standards - Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community. - Promote Avera’s values of compassion, hospitality, and stewardship. - Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity. - Maintain confidentiality. - Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment. - Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable. Benefits You Need & Then Some Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future. - PTO available day 1 for eligible hires. - Up to 5% employer matching contribution for retirement - Career development guided by hands-on training and mentorship Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org.

Location: Avera Health Broadband Lane Worker Type: Regular Work Shift: Day Shift (United States of America) Pay Range: The pay range for this position is listed below. Actual pay rate dependent upon experience. $18.50 - $24.25 Position Highlights You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview Accountable for securing or providing information relative to patients financial statuses or insurance coverage as needed in reference to patients bills. What you will do - Verifies daily admissions/discharges to ensure all billing info is properly completed and organized into daily batches to input into system. - Answers and addresses phone calls and messages, routing to necessary individual if needed. - Posts cash receipts in accounts receivable for self-pay and third party payments received. - Verifies that payments received are reimbursed correctly according to insurance contracts. - Runs cost estimates for patients and completes prior-authorization to ensure patients are approved for services. - Researches credit balances payment errors and refund issuers. Essential Qualifications The individual must be able to work the hours specified. 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. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer. Required Education, License/Certification, or Work Experience: - High School or GED Equivalent Preferred Education, License/Certification, or Work Experience: - Associate's Business Administration, Accounting or a related field. - 1-3 years relevant experience Expectations and Standards - Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community. - Promote Avera’s values of compassion, hospitality, and stewardship. - Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity. - Maintain confidentiality. - Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment. - Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable. Benefits You Need & Then Some Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future. - PTO available day 1 for eligible hires. - Up to 5% employer matching contribution for retirement - Career development guided by hands-on training and mentorship Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org.

Location: Avera Downtown Building-Sioux Falls Worker Type: Regular Work Shift: Primarily days with night, weekend and holiday on-call involvement (United States of America) Pay Range: The pay range for this position is listed below. Actual pay rate dependent upon experience. $63,960.00 - $96,200.00 Position Highlights The Informatics Analyst supports the ongoing use and optimization of Healthy Planet by partnering with clinical, operational, and technical teams to align workflows with system functionality, resolve issues, and promote effective population health, care coordination, and quality improvement efforts. You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview Provides basic support of multi-user clinical operating systems, hardware and software tools, including installation, configuration, maintenance, training and support of these systems. Participates in support of clinical applications applying developing clinical knowledge to ensure effective and optimal use of current applications, incorporation of enhancements and process improvements. Assesses current practice and translates end user needs into the optimal configuration and build of clinical applications. What you will do - Develops understanding and working knowledge of current clinical information systems, associated workflows and integration with other systems within the organization. Works collaboratively with system users, technical staff, other IT groups and vendor support resources in problem solving issues related to information systems. - Participates in planning, design, development, training, implementation, communication, maintenance and evaluation of existing or new functionality related to clinical information systems. Participates in execution of testing before system changes, updates or new functionality is moved to production environment. - Researches, plans, installs, configures, troubleshoots, maintains and upgrades operating systems and application software and hardware, developing knowledge regarding support of assigned systems. Participates in the process of planning new systems/processes or re-engineering, working collaboratively across the organization and multiple departments to support clinical practices and ensure development ,evaluation, and ongoing support for the EHR. - Maintains membership on, consultation to: appropriate committees, workgroups, or task forces as needed to facilitate the ongoing process of the design, implementation and revision of automated and manual components of clinical information systems. - Works with project managers and teams in implementations of new systems, system upgrades and enhancement of current system functionality, participating in any phase of large or small projects. Collaborates as appropriate on user requests for changes, enhancements, additions, etc. to ensure feasibility, quality and appropriateness for the system involved. - Maintains support material related to system implementations and maintenance such as routine updates, troubleshooting, issue resolution and product enhancements. - Facilitates reporting of information from source systems using the most appropriate tools. - Maintains up-to-date training materials for the systems as appropriate or works with the system educator to do so. Participates in training classes when appropriate. - Participates in the development and maintenance of quality improvement programs for clinical information systems proactively supporting efforts that ensure delivery of safe patient care and services. Contributes to the organization financially through identification and implementation of cost-effective practices and budget management activities. - Provides on call support to end users and the IT departments and serves as a resource to other team members in the areas of expertise. Essential Qualifications The individual must be able to work the hours specified. 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. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer. Required Education, License/Certification, or Work Experience: - Licensed Practical Nurse (LPN) - Board of Nursing active in state of practice. or - Registered Nurse (RN) - Board of Nursing active in state of practice. or - Certified Occupational Therapy Assistant (COTA) - National Board for Certification in Occupational Therapy (NBCOT) active in state of practice. or - Physical Therapy Assistant - Licensing Board active in state of practice. or - Registration for Electroencephalographic Technologists (R. EEG. T.) - American Board of Registration of Electroneurodiagnostic Technologists (ABRET) active in state of practice. or - Certified Medical Assistant (CMA) - American Association of Medical Assistants (AAMA) active in state of practice. or - Certified Medical Assistant (CMA) - American Medical Certification Association (AMCA) active in state of practice. or - Certified Clinical Medical Assistant (CCMA) - National Healthcareer Association (NHA) active in state of practice. or - National Certified Medical Assistant (NCMA) - National Center for Competency Testing (NCCT) active in state of practice. or - Certified Surgical Tech (CST) - National Board of Surgical Technology and Surgical Assisting (NBSTSA) active in state of practice. or - Tech in Surgery (TS-C) - National Center for Competency Testing (NCCT) active in state of practice. or - Occupational Therapist - Licensing Board active in state of practice. or - Physical Therapist - Licensing Board active in state of practice. or - Certified Nuclear Medical Technologist (CNMT) - Nuclear Medicine Technology Certification Board (NMTCB) active in state of practice. or - Medical Laboratory Technician (MLT) - American Medical Technologists (AMT) active in state of practice. or - Medical Laboratory Technician (MLT) - American Society for Clinical Pathology (ASCP) active in state of practice. or - Medical Laboratory Technician (MLT) - International - American Society for Clinical Pathology International (ASCPi) active in state of practice. or - Respiratory Therapist - Licensing Board active in state of practice. or - Certified Pharmacy Technician (CPhT) - National Healthcareer Association (NHA) active in state of practice. or - Certified Pharmacy Technician (CPhT) - Pharmacy Technician Certification Board (PTCB) active in state of practice. or - Speech-Language Pathologist - Licensing Board active in state of practice. or - Registered Cardiovascular Invasive Specialist (RCIS) - Cardiovascular Credentialing International (CCI) active in state of practice. or - ARRT Certification - American Registry of Radiologic Technologists (ARRT) active in state of practice. or - Medical Laboratory Scientist (MLS) - American Society for Clinical Pathology (ASCP) active in state of practice. or - Medical Laboratory Scientist (MLS) - International - American Society for Clinical Pathology International (ASCPi) active in state of practice. or - MLS - American Medical Technologists (AMT) active in state of practice. or - Medical Technologist (MT) - American Society for Clinical Pathology (ASCP) active in state of practice. Preferred Education, License/Certification, or Work Experience: - Bachelor's in related area. - Two years related experience and/or training. - Software-specific Certification, Accreditation or Proficiency, may be required for the specific software support. Expectations and Standards - Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community. - Promote Avera’s values of compassion, hospitality, and stewardship. - Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity. - Maintain confidentiality. - Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment. - Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable. Benefits You Need & Then Some Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future. - PTO available day 1 for eligible hires. - Up to 5% employer matching contribution for retirement - Career development guided by hands-on training and mentorship Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org.

Location: Avera Downtown Building-Sioux Falls Worker Type: Regular Work Shift: Day Shift (United States of America) Position Highlights This position will focus on HME (Home Medical Equipment) | DME (Durable Medical Equipment). Experience with HME, DME and Brightree a plus! You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview Responsible for aged accounts receivable (AR) follow up & denial review and appeals processes across assigned facilities at Avera. The Manager will develop and implement proactive practice procedures, tools, workflows to effectively provide a standardized approach to best manage inventory and revenue. This leader is responsible for setting department specific goals that align with the Revenue Cycle strategic plan. A successful leader uses employee engagement, development and anticipated staffing resources to accomplish these goals. A successful manager works effectively and collaborates with a variety of department leaders to understand complex issues and deliver creative solutions. What you will do - This position serves in a key leadership role to implement, monitor and facilitate improvement in the overall quality, timeliness and accuracy for department functions. - Work closely with next level leaders and other department leaders to implement new processes. - Create performance standards and holds employees accountable to standards through coaching, teaching and establish staffing levels and work with recruitment to identify and onboard individuals with diverse skills. - Collaboration with other department leaders to review identified trends and implement workflow that follow best practice and drive efficiency. - Identify reporting needs and work with Decision Support and IT on report design and implementation. - Review the KPI’s to identify trends and areas of opportunity and create action plans with supervisors and team members to optimize. - Responsibilities include interviewing, hiring, developing, training, and retaining employees; planning, assigning, and leading work; appraising performance; rewarding and coaching employees; addressing complaints and resolving problems. Essential Qualifications The individual must be able to work the hours specified. 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. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer. Required Education, License/Certification, or Work Experience: - Bachelor's in business, economics, management, accounting or related field; or three to four years of related experience and/or training; or an equivalent combination of education and experience. Expectations and Standards - Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community. - Promote Avera’s values of compassion, hospitality, and stewardship. - Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity. - Maintain confidentiality. - Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment. - Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable. Benefits You Need & Then Some Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future. - PTO available day 1 for eligible hires. - Up to 5% employer matching contribution for retirement - Career development guided by hands-on training and mentorship Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org.

Location: Avera Health Worker Type: Regular Work Shift: Day Shift (United States of America) Pay Range: The pay range for this position is listed below. Actual pay rate dependent upon experience. $19.50 - $25.50 Position Highlights You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview Responsible for ensuring insurance eligibility, benefit verification, and the authorization processes are complete in the time allowed by the insurance companies to prevent denials or penalties. Specialists are responsible for documenting accurate insurance information and authorization details to optimize reimbursement from both the payer and patient. The Specialist must maintain strong working knowledge of insurance plans, contract requirements, and resources to facilitate appropriate insurance verification and authorization. Specialists must also be able to understand and interpret patient liability and benefits for all payer types including copays, co-insurance, and out-of-pocket responsibilities in order to provide patients and families with information on their financial responsibility. The Specialist will calculate and communicate to the patient a financial responsibility estimation, provide charity applications and/or direct the patient to the business office for payment and assistance options. The Specialists will collect patient liability prior to service and attempt to collect prior balances. The Specialist collaborates with various other departments to ensure proper reimbursement on accounts. The Specialists are to conduct all transactions appropriately and consistently, and complete government regulatory forms accurately with the patient or patient's representative. Specialists must maintain compliance with government regulations (i.e. EMTALA and HIPAA) as it pertains to the insurance process. What you will do - Process eligibility and secure full benefit coverage information (including COBRA when applicable) with insurance companies and employers, confirm all demographic information is correct, and ensure coordination of benefit (COB) and insurance plan codes are accurate. Specialists must verify insurance coverage immediately for inpatient and outpatient accounts that are same day and next day add-ons. - Identify all payment sources for accurate primary and secondary payer coverage and required authorizations to prevent denials and/or reduction in payment for patients entering the facility for care. - Obtain necessary paper/electronic referrals, authorizations and pre-certifications from Primary Care Physician and/or Specialty Physician when required by payers, Managed Care, and traditional Medicaid and enters information into the health information system. - Collects and validates accurate patient demographic and insurance information, verifies insurance, obtains pre-certification/authorization as required and enters all necessary information. - Calculate and communicate patient estimates for hospital services utilizing a deposit matrix or patient payment estimator to determine estimated patient responsibility and communicates financial expectations to the patient. - Educates patients on their benefits, offers the patient/family the opportunity to pay their estimated patient responsibility prior to services rendered, and identifies methods of payment available. Identifies patients in need of financial assistance and provides charity applications and referrals to the business office as necessary. - Responsible to screen all self pay patients for potential payer coverage and directs applicable accounts to the advocacy team for further review. Assure all payer requirements are met, including non-coverage waivers, Advance Beneficiary Notices, sterilization forms, and other forms as applicable. - Provide communication concerning change of insurance coverage, prior to billing, from Registration staff and/or Patient Advocate/Billing staff. - Maintain professional development by attending workshops, in-services, and webinars to remain up-to-date on insurance rules and regulations in addition to changes within the industry. Essential Qualifications The individual must be able to work the hours specified. 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. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer. Required Education, License/Certification, or Work Experience: - 1-3 years Related experience in billing, insurance or registration. - 1-3 years Healthcare experience Preferred Education, License/Certification, or Work Experience: - Associate's finance, business or healthcare. Expectations and Standards - Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community. - Promote Avera’s values of compassion, hospitality, and stewardship. - Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity. - Maintain confidentiality. - Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment. - Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable. Benefits You Need & Then Some Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future. - PTO available day 1 for eligible hires. - Up to 5% employer matching contribution for retirement - Career development guided by hands-on training and mentorship Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org.

Location: Avera Downtown Building-Sioux Falls Worker Type: Regular Work Shift: Day Shift (United States of America) Pay Range: The pay range for this position is listed below. Actual pay rate dependent upon experience. $25.50 - $38.25 Position Highlights EPIC EMR and Charge Capture experience and/or payment integrity preferred Opportunity to work remote within the Avera footprint: SD, NE, MN, IA You Belong at Avera Be part of a multidisciplinary team built with compassion and the goal of Moving Health Forward for you and our patients. Work where you matter. A Brief Overview The Revenue Integrity Analyst is responsible for enhancing financial performance, ensuring accurate charge capture, and securing appropriate reimbursement across the revenue cycle. This role combines expertise in analytics, charge auditing, and payment integrity to support strategic decision-making, operational efficiency, and compliance. 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. What you will do - Design, maintain, and enhance dashboards and scorecards for denials, write-offs, payer performance, and charge activity. Analyze trends and translate complex data into actionable insights for stakeholders. - Conduct audits and Revenue Guardian checks to validate charge accuracy and completeness. Perform payer-specific audits and monitor ED Discharge and Charge Tracker Reports. - Monitor and resolve Discharged Not Billed (DNB) accounts to ensure timely claim submission. - Investigate denials and underpayments, identify root causes, and recommend process improvements. - Manage appeals for underpaid claims, track outcomes, and report on recovery efforts and payment trends. - Review high-dollar write-offs for appropriateness and escalate discrepancies as needed. - Oversee Post-Service Single Case Agreements (SCAs) to ensure reimbursement accuracy and adherence to contract terms. - Partner with clinical, operational, and payer relations teams to resolve discrepancies and improve documentation. - Participate in audits, strategic initiatives, and projects aimed at financial optimization and revenue integrity. Essential Qualifications The individual must be able to work the hours specified. 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. These requirements and those listed above are representative of the knowledge, skills, and abilities required to perform the essential job functions. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions, as long as the accommodations do not cause undue hardship to the employer. Required 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. - Two to three years experience in healthcare revenue cycle analytics, charge auditing, or payment integrity. - Knowledge of healthcare billing, denial management, and/or payer reimbursement methodologies. Preferred Education, License/Certification, or Work Experience: - Bachelor's - Certified Revenue Cycle Representative (CRCR) - Healthcare Finance Management Association (HFMA) Upon Hire or - Certified Specialist Payment & Reimbursement (CSPR) - Healthcare Finance Management Association (HFMA) Upon Hire - Proficiency in data visualization tools (e.g. Power BI, Tableau) and Excel - Experience with Epic reporting tools (e.g., SlicerDicer, Reporting Workbench, Clarity, billing and contract modules) Expectations and Standards - Commitment to the daily application of Avera’s mission, vision, core values, and social principles to serve patients, their families, and our community. - Promote Avera’s values of compassion, hospitality, and stewardship. - Uphold Avera’s standards of Communication, Attitude, Responsiveness, and Engagement (CARE) with enthusiasm and sincerity. - Maintain confidentiality. - Work effectively in a team environment, coordinating work flow with other team members and ensuring a productive and efficient environment. - Comply with safety principles, laws, regulations, and standards associated with, but not limited to, CMS, The Joint Commission, DHHS, and OSHA if applicable. Benefits You Need & Then Some Avera is proud to offer a wide range of benefits to qualifying part-time and full-time employees. We support you with opportunities to help live balanced, healthy lives. Benefits are designed to meet needs of today and into the future. - PTO available day 1 for eligible hires. - Up to 5% employer matching contribution for retirement - Career development guided by hands-on training and mentorship Avera is an Equal Opportunity Employer - Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, Veteran Status, or other categories protected by law. If you are an individual with a disability and would like to request an accommodation for help with your online application, please call 1-605-504-4444 or send an email to talent@avera.org.