DaVita HealthCare Partners Inc
GENERAL PURPOSE OF THE JOB
This position provides timely assessment, education, and guidance to patients regarding their insurance and the implications of different options enabling the patient to make informed decisions and ensuring insurance related issues are resolved. This position's primary focus is reducing or eliminating the amount of patient and facility liability while providing accurate and timely patient, revenue and treatment trend reporting. This position also identifies, resolves, or escalates satisfaction concerns of all patients to ensure DaVita is the provider of choice.
ESSENTIAL DUTIES AND RESPONSIBILITIES
The following duties and responsibilities generally reflect the expectations of this position but are not intended to be all inclusive.
Patient Interaction and Commercial Retention
Meets with new patient to discuss insurance assessment
Educate patient of financial rights and responsibilities
Identify and communicate effectively opportunities to better the insurance status of the patient, alleviating financial risk and burden for patient and facility
Initiate appropriate and necessary paperwork ensuring least amount of patient and facility liability
Timing of new patient visit dependant on patient risk factors, ranging from 2 weeks to 30 days from first day of treatment at DaVita facility
Provide high-level of customer service to patients to ensure patient needs are met
Act as a liaison between patients, facility teammates, billing office and the corporate office to resolve patient insurance issues and/or concerns; proactively establish relationships with patients
Maintain relationship with existing patients
Identify, resolve or escalate issues (insurance, billing, and satisfaction) as appropriate for prompt and effective resolution
Support patient collection activities as necessary, especially where payer sends payments directly to patient
Assist patients in retaining or obtaining insurance coverage
Research and communicate effectively to the patient additional insurance options for primary and/or secondary coverage
Through signed release of information, advocate on behalf of patient in researching and resolving financial issues and insurance options with employer, insurance company or other available entities seen fit
Establish and build relationships with clinical and regional resources (DVP, ROD, FA) to emphasize and integrate Insurance Management priorities
Review patient lists with Facility Administrators and teammates to identify potential patient insurance issues
Partner with Social Workers to maintain awareness of patient insurance questions
Distribute tracking reports to social work teammates and supply any additional tools or education that may be necessary
Identify and brainstorm to resolve difficult situations that may impact a patient's level of financial liability
Partner with Social Worker and/or other Facility teammates for continued follow through of processing any necessary applications or forms to ensure least liability for patient and facility
Support presentation development and distribution of educational tools on insurance information for field teammates
Provide training to clinical teammates to anticipate and recognize changes in patient insurance coverage as necessary
Provide monthly reporting and analysis on key metrics related to patient growth and retention to senior management
Compile monthly operations reviews on assigned patient portfolio
Participate in SAMs calls as necessary to report status of patient losses or potential losses
Other duties and responsibilities as assigned
Attend team meetings, phone conferences, and training as needed
Know, understand, and follow teammate guidelines, employment policies, and department or company procedures
Participate as requested in special projects and Insurance Management team initiatives
Mentor team members as appropriate on Insurance Management practices
Shadow new hires to mentor and to provide training as needed
Inform transient commercial patients about DaVita services and DaVita facilities in patients' local areas
Participate in growth and/or branding activities for new commercial patients as needed
Travel required: up to 85%
Here is what you can expect when you join our Village:
A community first, company second culture based on Core Values that really matter.
Clinical outcomes consistently ranked above the national average.
Award-winning education and training across multiple career paths to help you reach your potential.
Performance-based rewards based on stellar individual and team contributions.
A comprehensive benefits package designed to enhance your health, your financial well-being and your future.
Dedication, above all, to caring for patients suffering from chronic kidney failure across the nation.
Qualifications (Education, licenses, certifications, and experience required to fulfill the essential duties, include computer skills as required) High school diploma or equivalent required
Bachelor's degree preferred
Minimum of two (2) years' experience in customer service, healthcare organization and/or insurance company
Experience in a healthcare organization working with a clinical team and patients strongly preferred
Demonstrative extensive understanding of insurance plans and benefits (PPO, HMO, POS, EPO, Indemnity) required
Demonstrative understanding of COBRA benefit options and Coordination of Benefits strongly preferred
Demonstrative understanding of Federal and State level health coverage benefits as they relate to ESRD strongly preferred
Intermediate computer skills and proficiency in MS Word, Excel, PowerPoint, and Outlook required
ESSENTIAL BEHAVIORS, SKILLS, AND ATTITUDES REQUIRED FOR SUCCESS IN THIS POSITION
Commitment to DaVita's values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment and Fun with ability to demonstrate those positively and proactively to patients, teammates, management, physicians, and/or vendors (Village Service Partners) in everyday performance and interactions
Demonstrated strengths in organizational, attention-to-detail, follow-through, analytical, reasoning, critical thinking, and problem solving skills
Excellent written, verbal, and interpersonal communication skills with an acute ability to listen attentively and to communicate effectively throughout all levels of the organization, external insurance companies, and patients
Ability to explain insurance information to audiences with varying degrees of familiarity with material
Demonstrated professionalism and courtesy in responding to phone calls and emails
Demonstrated ability to work well with cross-functional groups and field operators
Demonstrated interpersonal, collaborative, and relationship-building skills
Approachable and open
Demonstrated ability to influence others
Demonstrated time management skills and ability to handle multiple priorities with shifting time frames and meet deadlines; self-starter with high degree of initiative, urgency, and follow through
Ability to function independently and as a member of a team and to foster a positive work environment
Innovative approach to problem solving
Demonstrated ability to present and document work according to standards required; ability to provide multi-level reporting and communication
Demonstrated ability to maintain absolute confidentiality concerning information accessed
Fluent in the written and verbal skills necessary to perform successfully the essential functions, duties, and responsibilities of the position.
Vision adequate to perform essential duties and responsibilities of position.
Physical requirements can vary. These must be reviewed with management. However, in general, the position requires the following physical activities:
Ability to lift minimum of 2 pounds to a maximum of 15 pounds unassisted; able to sit for extended periods of time with some standing, stooping, walking, stretching, reaching; moderate range of body motions.
Ability to hear and interact by phone clearly and efficiently.
Ability to use computer and all peripherals for extended periods of time.
Level III - Moderate noise (examples: business office with computers and printers, light traffic)
No required tasks involve greater exposure to blood, body fluids or tissues than would be encountered by a visitor. The normal work routine involves no exposure to blood, body fluids or other hazardous conditions. Normal hazards associated with business travel.
Join us as we pursue our vision To Build the Greatest Healthcare Community the World has Ever Seen.
Why wait? Explore a career with DaVita today.
Go to http://careers.davita.com to learn more or apply.
To learn more about our Village and the world of dialysis, click here .
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DaVita is an equal opportunity/affirmative action employer. As such, DaVita makes hiring decisions solely on the basis of qualifications and experience, and without regard to age, race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status.
We maintain a drug-free workplace and perform pre-employment substance abuse testing and background verification checks.
DaVita will consider qualified applicants who have criminal histories in a manner consistent with the law.
DaVita HealthCare Partners Inc
Website : http://www.davita.com
DaVita is the dialysis division of DaVita HealthCare Partners Inc., a Fortune 500® company that, through its operating divisions, provides a variety of health care services to patient populations throughout the United States and abroad. A leading provider of kidney care in the United States, DaVita delivers dialysis services to patients with chronic kidney failure and end stage renal disease. DaVita strives to improve patients’ quality of life by innovating clinical care, and by offering integrated treatment plans, personalized care teams and convenient health-management services. As of December 31, 2013, DaVita operated or provided administrative services at 2,074 outpatient dialysis centers located in the United States serving approximately 163,000 patients. The company also operated 73 outpatient dialysis centers located in 10 countries outside the United States. DaVita supports numerous programs dedicated to creating positive, sustainable change in communities around the world. The company’s leadership development initiatives and social responsibility efforts have been recognized by Fortune, Modern Healthcare, Newsweek and WorldBlu.