Payor Partnerships Specialist

🕒 vor 3 Tagen

🐎 Kentucky, New Mexico, +3 weitere Bundesländer – Remote

🐎 Kentucky – Remote 🌶️ New Mexico – Remote 🔔 Pennsylvania – Remote ☕ Washington – Remote 🧀 Wisconsin – Remote

💵 $22 - $28 / Stunde

⏰ Vollzeit

🟢 Junior

🟡 Mittelstufe

💰 Account Manager

🚫👨‍🎓 Kein Abschluss erforderlich

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DaVita Kidney Care

WebsiteLinkedInAlle Stellen

10.000+ Mitarbeiter

Gegründet 1994

⚕️ Krankenversicherung

💰 Post-IPO Debt im 2021-02

Healthcare Insurance

DaVita Kidney Care ist ein führendes Gesundheitsunternehmen, das Dialyse und verwandte Behandlungen für Patienten mit Nierenerkrankungen anbietet. Mit dem Bestreben, die Lebensqualität seiner Patienten zu verbessern, konzentriert sich DaVita darauf, eine integrierte Nierenversorgung zu bieten und sein vielfältiges Team von Fachkräften im Gesundheitswesen, einschließlich Krankenschwestern, Ernährungsberatern, Sozialarbeitern und Pflegefachleuten, zu unterstützen. Das Unternehmen legt großen Wert auf eine starke Unternehmenskultur, Karriereentwicklung und umfassende Sozialleistungen, um ein inklusives und unterstützendes Arbeitsumfeld für seine Mitarbeiter zu schaffen.

Beschreibung

• 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. • Prioritize tasks based on risk and value (e.g., Fee For Service Agreements, Document Reviews, Facility Status Requests, New Center Additions, Acquisitions).

🎯 Anforderungen

• 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.

🏖️ Vorteile

• 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.