Specialist II, Contract Operations

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🕒 Junho 12

🏈 Alabama, Iowa, +3 estados a mais – Remoto

🏈 Alabama – Remote 🌾 Iowa – Remote 🌶️ New Mexico – Remote ❄️ Minnesota – Remote ☕ Washington – Remote

💵 $22 - $28 / hora

⏰ Tempo Integral

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🟡 Pleno

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🚫👨‍🎓 Sem graduação necessária

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DaVita Kidney Care

SiteLinkedInTodas as Vagas

10.000+ funcionários

Fundada em 1994

⚕️ Seguro de Saúde

💰 Post-IPO Debt em 2021-02

Healthcare Insurance

DaVita Kidney Care é uma empresa líder em saúde que oferece diálise e tratamentos relacionados para pacientes com doença renal. Comprometida em melhorar a qualidade de vida de seus pacientes, a DaVita foca em oferecer cuidado renal integrado e em apoiar sua equipe diversa de profissionais de saúde, incluindo enfermeiros, nutricionistas, assistentes sociais e técnicos de atendimento ao paciente. A empresa valoriza uma cultura forte, o desenvolvimento de carreira e benefícios abrangentes para criar um ambiente de trabalho inclusivo e de apoio para seus colaboradores.

Descrição

• Accurate and timely contract reviews with regards to Best Demonstrated Performance language, check lists, codes, rates, and credentialing operational language • Independently research and resolve complex network and claims issues by collaborating with Credentialing Specialists and Negotiation teams • Analyze root causes of delays or denials using tools such as the A3 worksheet format • Assess complex situations and communicate effectively to leadership using the SBAR (Situation, Background, Assessment, Recommendation) format • Maintain accurate data across multiple systems (Orion, CLM, COR, Salesforce, and IBM-based data systems) • Provide data for weekly reports, including task categories, email volume, out of SLA task assistance and escalation tracking • Maintain an average Quality Assurance (QA) score at or above 95% for critical errors • Build and maintain strong professional relationships with external payor contacts to facilitate efficient processing. • Collaborate with internal " Partners" to proactively resolve account issues • Manage an extremely high volume of work, including maintaining email inbox counts below 40 and responding to requests within 1-2 business days.

🎯 Requisitos

• High school diploma or equivalent required; Associate’s or Bachelor’s degree preferred • Minimum 2 years of experience in high-volume research, Customer Accounts ownership or complex administrative resolution work • Proven track record of top performance in a production-based environment • Advanced Excel Skills Required: Must have experience at the formula writing level (e.g., complex IF statements, VLOOKUP, mail merge integration, conditional formatting) • Strong proficiency in Microsoft Outlook (managing high email volume), Word, PowerPoint, and SharePoint • Experience with Salesforce or database management systems preferred.

🏖️ Benefícios

• Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out • Support for you and your family: Family resources, EAP counseling sessions, access Headspace ® , backup child and elder care, maternity/paternity leave and more • Professional development programs: DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita’s online training platform StarLearning.