Sr Analyst, Business (ROPS)

DaVita Kidney Care01548 - Texas Remote, TX
$70,000 - $106,000Onsite

About The Position

DaVita is seeking a Superstar to join their Village as a Sr Analyst, Business (ROPS). This role involves initiating and maintaining communication with facilities to ensure timely and accurate receipt of patient insurance coverage information, entering this information into the billing system, and verifying patient insurance with payors, including eligibility and benefits related to outpatient kidney dialysis. The analyst will update patient registration and associated systems, coordinate with Patient Referral Coordinators to obtain required documentation, and partner with facility and Insurance Management Teams to resolve incomplete registrations. Additionally, the role requires reviewing registration denials to determine root causes, resolving patient account errors, and identifying process changes to prevent future denials. The analyst will also determine Coordination of Benefits, maintain current patient account information, and submit internal requests to ensure accurate and timely claims submission. Completing ancillary reports, assigned projects, and supporting other teammates are also key responsibilities. Maintaining confidentiality of company and patient information in accordance with HIPAA regulations and DaVita policies is essential. The position may require overtime with little or no notice, attendance at team meetings, and adherence to teammate guidelines, employment policies, and department or company procedures. Consistent, regular, and punctual attendance is an essential responsibility.

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
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