Clinical Programs Sr Analyst (Clinical Transformation)

DaVita Kidney Care

1d • $62,000 - $95,000 • Onsite

About The Position

This position is for a Clinical Programs Sr Analyst (Clinical Transformation) at DaVita. The role involves validating patient insurance information through the patient intake process to complete patient registration. The teammate ensures timely and accurate claims submission for assigned dialysis centers within a geographic region, adhering to DaVita policies and federal/state billing regulations. DaVita emphasizes a "Community first, Company second" culture with Core Values like TEAM and FUN, and is dedicated to caring for patients with chronic kidney failure.

Requirements

• High school diploma or equivalent required
• Basic computer skills and proficiency in MS Word, Excel, and Outlook required

Nice To Haves

• Minimum of three (3) years' healthcare reimbursement experience preferred
• Experience with admissions, billing, and collections preferred
• Demonstrated knowledge of insurance rules, regulations and Coordination of Benefits for federal, state, and managed care payors in multiple states preferred

Responsibilities

• Initiate and/or maintain ongoing communication with facilities to ensure timely and accurate receipt of each patient's insurance coverage information
• Enter insurance information into billing system
• Verify patient insurance with payors including eligibility and benefits related to outpatient kidney dialysis
• Update Patient Registration and associated systems accurately and as required
• Coordinate and partner closely with Patient Referral Coordinators (PRC) to obtain required documentation for successful patient registration
• Partner with facility and Insurance Management Team to resolve incomplete registrations
• Review registration denials received to determine root cause
• Resolve patient account errors that cause registration denials
• Help identify process changes to prevent failed registrations
• Determine Coordination of Benefits as required; maintain current patient account information at all times
• Follow-up as necessary to ensure insurance changes are verified and line of coverage is reset
• Submit internal requests, including but not limited to RCUs, SMARTFORMS, PCS Inquiries, SPA Requests, etc., to ensure accurate and timely claims submission to the correct payor
• Complete all ancillary reports and assigned projects within established timeframes
• Support Patient Account Representatives and other ROPS teammates as needed
• Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies
• Work overtime with little or no notice as needed
• Attend team meetings, phone conferences, and training as needed
• Know, understand, and follow teammate guidelines, employment policies, and department or company procedures
• Consistent, regular, punctual attendance as scheduled is an essential responsibility of this position

Benefits

• Medical, dental, vision, 401(k) match, paid time off, PTO cash out
• Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave
• Professional development programs
• On-demand virtual leadership and development courses through DaVita’s online training platform StarLearning

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: High school or GED