RCM Revenue Specialist III (Insurance Verification/denials/claims)

at  DaVita

EXPERIENCE AND REQUIRED SKILLS

• Previous medical billing revenue cycle experience: An in-depth understanding of full-cycle revenue is required. From patient demographics/insurance to charge posting, payments received, account adjustments and final resolution of patient accounts is necessary.
• Excellent critical thinking and problem-solving skills: Every patient account and every insurance payor offers its own set of unique challenges. The ability to think through a situation and carefully identify the best action to take is critical to be successful at this role
• Strong communication and interpersonal skills: The position involves regular communication with billing vendor, as well as relationship building and interaction with other teammates
• Ability to adapt quickly: Our environment can change quickly on a daily basis. Adapting and demonstrating resiliency are key.
• Ownership: Teammates in this position will own a book of business. With some support of their leadership, teammates in this role should demonstrate drive and initiative to work through their queue.
• Creating a Special Place: Understands and embraces the DaVita culture.

MINIMUM QUALIFICATIONS:

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

WHAT WILL YOU DO?

This position performs revenue cycle duties including but not limited to:
Researching patient insurance and demographic information for accuracy, responding to billing vendor questions on patient accounts, reviewing and reconciling insurance billing issues.

EXAMPLE OF DAILY RESPONSIBILITIES INCLUDES:

• Perform duties for revenue operations related to either medical insurance coverage accuracy, or working with billing vendor to resolve credits on accounts
• Research to find patient insurance and demographic information (multiple online sites) and sharing information with billing vendor
• Communicate with billing vendor to ensure proper insurance coverage for our patients
• Respond timely and accurately to billing vendor requests
• Resolving credits when overpayments are received from payers and refunds need to be issued.
• Collaborate with other revenue operations teams to ensure seamless processes across teams
• Help identify process changes and opportunities for continuous improvements
• Maintain current patient account information at all times
• Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies

OTHER DUTIES COULD INCLUDE:

• May be asked to work overtime as needed
• Attend team meetings, phone conferences, and training as needed
• Know, understand and follow teammate guidelines, employment policies, and department or company procedures