DaVita Insurance Representative in Chandler, Arizona
Provide insurance verification services for all referrals sent to and processed by DaVita Specialty to determine whether the referral will be eligible to be served by DaVita Rx Specialty. These services are to include investigating and confirming insurance eligibility, benefits, and coverage and obtaining any required prior authorizations or approvals from the referral’s Third Party Payer.
Determine insurance eligibility for all referrals through direct payer call and/or electronic means and chart accordingly per SOP’s
Determine patient benefits including financial responsibility and chart accordingly in Operating System per SOP’s
Work with all 3rd party payers to determine coverage requirements and confirm that the referral meets or does not meet that payer’s coverage requirements
Work with MD Office to initiate and obtain Prior Authorization if required as per DaVita Rx SOP’s
Communicating with MD Office to obtain or provide required info for insurance verification or prior authorization, including PA denial and appeal follow up.
The Shining Star in this role should have:
High School diploma or equivalent required; some college preferred
Understanding of healthcare insurance coverage fundamentals including major payers, common insurance coverages, and Coordination-of-BenefitsInsurance Verification experience in pharmacy provider, MD Office, or comparable healthcare provider organization
Prior Authorization experience in pharmacy provider, MD Office, or comparable healthcare provider organization
Communication skills and experience with physician office, 3rd party payer, and patient customers
Healthcare operating system experience including data entry, record look-up and viewing, etc.
Experience with healthcare EDI systems including eligibility and benefitsTroubleshooting and problem solving skills to assess and solve complex situations
The DaVita Village Difference
Industry-leading patient care with clinical outcomes ranked above the national average.
Dynamic leadership grounded in Core Values, Mission and clearly defined goals for you.
Diverse, team-driven culture that supports you.
Commitment to developing you and the chance to explore multiple career paths.
Stability and strong financial results - 10 years of steady revenue growth.
Performance-based compensation and rewards for your hard work.
A commitment to the greater good: We are a community first, a company second.
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Go to http://careers.davita.com to learn more or apply. Or send your resume to Name, Title, at first name.last email@example.com .
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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.