DaVita Payor Specialist in Irvine, California

The purpose of this position is to identify and maintain in DaVita’s systems, Medicare, Medicaid, Government Program, Commercial, and Contracted payor requirements, specifically related, but not limited to claim formatting, billing, and claim submission guidelines.

ESSENTIAL DUTIES AND RESPONSIBILITIES :

The following duties and responsibilities generally reflect the expectations of this position but are not intended to be all inclusive.

  • Track and follow up on all Medicare, Medicaid, Government Programs, Commercial and Contracted Payor issues through the Remedy system with a concentration on root cause analysis and resolution
  • Follow up with payor representatives and communicate issues and their resolution to customers within Revenue Operations and other impacted departments
  • Monitor workflow system to ensure Payor issues are addressed daily and followed up on time
  • Identify updates and/or changes to payor requirements prior to implementation and work with applicable Revenue Operations teams to ensure those changes are accurately reflected in all legacy systems
  • Work directly with payor representatives, and/or third party clearinghouse, or teammates to resolve reported payor issues
  • Serve as liaison between the Payor Contracting and ROPS Payor Specialist Team on all payor issues related, but not limited to claim formatting, rates, and all applicable payor requirements
  • Communicate issues pertaining to all payor issues, the root causes, and resolutions to upper management
  • Identify and communicate payor and claim level requirements to impacted areas within Revenue Operations department
  • Ensure that payor and claim level issues are corrected in legacy billing system when applicable
  • Understand and follow DaVita teammate handbook and safety and security policy and procedures
  • Report any injury on the workplace premises to a member of the management team or People Services immediately
  • Some light travel required 10%

Other duties and responsibilities as assigned including but not limited to:

  • Work overtime with little or no notice as needed
  • Attend team meetings, phone conferences, and training as needed
  • Know, understand, and follow teammate guidelines, employment policies, and department or company procedures
  • Consistent, regular, punctual attendance as scheduled is an essential responsibility of this position

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.

MINIMUM QUALIFICATIONS:

(Education, licenses, certifications, and experience required to fulfill the essential duties, include computer skills as required):

  • High School diploma or equivalent, 1-3 months related experience or training, or combination of education and experience required
  • Basic computer skills and proficiency in MS Word, Excel, PowerPoint, and Outlook required
  • Intermediate skills in electronic billing systems preferred
  • Experience with healthcare reimbursement issues, especially as related to commercial and government payors and the electronic submission of claims

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, co-workers, management, physicians, and/or vendors in every day performance and interactions
  • Demonstrated strengths in organization, 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
  • Demonstrated commitment to customer service; proactively communicate and respond promptly to teammate needs
  • Self-directed; able to work independently and as a member of a team and to foster a positive work environment

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 orprotectedveteran status.

We maintain a drug-free workplace and perform pre-employment substance abuse testing and background verification checks.