Payor Partnerships Specialist

🕒 il y a 2 jours

🐎 Kentucky, New Mexico, +3 états de plus – Distant

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

💵 $22 - $28 / heure

⏰ Temps Plein

🟢 Junior

🟡 Intermédiaire

💰 Responsable de comptes

🚫👨‍🎓 Aucun diplôme requis

Postuler Maintenant

Trouver des Emplois à Distance Similaires

Recevoir des emails pour des emplois à distance

📊 Vérifiez votre score de CV pour ce poste

Améliorez vos chances d'obtenir un entretien en vérifiant votre score de CV avant de postuler.

Télécharger le CV

DaVita Kidney Care

Site WebLinkedInTous les Emplois

10 000+ employés

Fondée en 1994

⚕️ Assurance santé

💰 Post-IPO Debt en 2021-02

Healthcare Insurance

DaVita Kidney Care est une entreprise leader dans le domaine des soins de santé qui fournit des dialyses et des traitements associés aux patients atteints de maladies rénales. Engagée à améliorer la qualité de vie de ses patients, DaVita se concentre sur une prise en charge rénale intégrée et soutient son équipe diversifiée de professionnels de la santé, incluant des infirmiers, des diététiciens, des assistants sociaux et des techniciens de soins aux patients. L'entreprise met l'accent sur une culture forte, le développement de carrière et des bénéfices complets pour créer un environnement de travail inclusif et favorable pour ses employés.

Description

• 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).

🎯 Exigences

• 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.

🏖️ Avantages

• 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.