Insurance Counselor I (ROPS)

DaVita • Richmond, VA

11h • Onsite

About The Position

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.

Requirements

• 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)
• 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

Nice To Haves

• Bilingual/Spanish preferred

Responsibilities

• 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
• Help patients obtain as close to 100% insurance coverage for patients as possible by educating on 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 a patients financial situation( 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 educate on what options are available for their specific situation.
• 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
• 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 education and advocacy to senior management
• Compile monthly operations reviews on assigned patient portfolio
• Participate in scheduled SAMs calls to review patient portfolio with designated facility teammate
• 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

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 and more
• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees