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.
(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.
DaVita is proud to be an EEO/AA employer M/F/D/V.
We maintain a drug-free workplace and perform pre-employment substance abuse testing and background verification checks.