GENERAL PURPOSE OF THE JOB
This position provides guidance and information to patients on insurance and the implications of different insurance options to allow patients to make informed insurance decisions. This position ensures that commercial patients' insurance questions are addressed and resolved, assists in securing secondary coverage for Medicare No Secondary patients, and assists under-insured and uninsured/pending coverage patients with eligibility and/or coverage options. Position provides accurate and timely patient, revenue, and treatment trend reporting to the Group insurance Manager and operations teams that it supports.
ESSENTIAL DUTIES AND RESPONSIBILITIES
The following duties and responsibilities generally reflect the expectations of this position but are not intended to be all inclusive.
Act as a liaison between patients, facility teammates, billing office and the corporate office to resolve patient insurance issues and/or concerns
Identify, resolve or escalate issues as appropriate for prompt and effective resolution
Proactively build relationships with patients
Proactively review patient lists with Facility Administrators and teammates to identify potential patient insurance issues
Proactively build relationships with clinical and regional resources to emphasize and integrate Insurance Management priorities
Support education on and completion of Patient Financial Evaluations to determine if payment or payment arrangements are an option
Help patients find potential payment plan options
Obtain as close to 100% insurance coverage for patients as possible by exploring all avenues and coverages
Ensure that patients who qualify have 100% coverage (excluding non-compliant patients)
Support patient collection activities as necessary by educating patients about balances due and encouraging them to work with the billing office to resolve
Identify any DaVita programs that would help (i.e. Patient Financial Evaluations)
Assist patients and Social Workers with applications for charitable assistance as necessary
Partner with Social Workers to maintain awareness of patient insurance questions
Assist Medicare patients with securing secondary insurance coverage
Assist patients and/or Social Workers as necessary to determine if cash repayment is an option
Research commercial patients' financial issues and insurance options and assist patients in retaining commercial insurance coverage
Review additional insurance options for primary and/or secondary coverage
Provide high-level of customer service to ensure patient questions or issues are addressed effectively
Provide information to patients to help them find and/or secure all options for insurance coverage
Facilitate Conference calls
Facilitate weekly team calls partnering with facility and billing office teammates to ensure smooth registration process
Proactively manage insurance terminations or changes
Identify registration process improvement opportunities
Brainstorm and help resolve incomplete or problematic registration challenges
Manage and update tracking tools as appropriate
Review trends with team and operational leadership
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 scheduled SAMs calls to review patient portfolio with designated facility teammate
Other duties and responsibilities as assigned including but not limited to:
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
Travel Required: up to 85% within assigned area
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
Minimum of two (2) years' experience working with Medicare and Medicaid insurance as well as commercial insurance plans and benefits (PPO, HMO, POS, EPO, Indemnity) required
Current driver's license in state of residence and insurable driving record required
Minimum of two (2) years' experience in a healthcare organization working with clinical staff and patients preferred
Intermediate computer skills and proficiency in MS Word, Excel, PowerPoint, and Outlook required