Job Abstract

Sr. Revenue Cycle Specialist: Medicaid Collections (remote)

Would you like to work for a company with Core Values such as TEAM and FUN?  Do you want your work to make a difference?  Are you looking to build your career in healthcare?  Then, join our growing team, which offers abundant opportunities to develop your professional and personal skills, advance your career, and positively impact our patients' lives.

We are looking for a Senior Medicaid Collections Specialist whose primary responsibilities are to maximize reimbursement from fee-for-service Medicaid plans by resolving denials, short payments, billing errors, and other claim issues.  The ideal candidate is a self-motivated individual that demonstrates strong critical thinking skills and can resolve complex problems with little leadership guidance or intervention.  Individuals who excel in this role are ambitious, results-driven, and robust in root cause analysis.  In addition, this position requires attention to detail, strong written and verbal communication skills, and the ability to work well as part of a fast-paced team.   

Fully remote optional.  All necessary equipment and training to be successful in this position will be provided.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Identify trends, conduct follow-up, and perform root cause analysis on unpaid and underpaid Medicaid and managed plan insurance claims
• Research, appeal, and address claim rejections, underpayments, and denials according to policy and procedure (including but not limited to rebilling, correcting coding, calling the payer or clinic, and utilizing payor portals)
• Resolve issues related to a patient's coordination of benefits (COB), demographic discrepancies, and Medicare/Medicaid eligibility
• Identify and rectify billing issues related to updates outlined in Medicaid provider manuals and provider bulletins
• Address patient benefit-related denials, including phone verification of plan requirements, financial risk, as well as other factors that may impact reimbursement
• Navigate through various payer systems, provider portals, and internal DaVita applications to ensure timely and accurate claim resolution
• Demonstrate ability to build strategic business relationships with internal and external partners (i.e., the Billing & Coding Team, Registration Department, Medicare Collections Team, Credit Department, and the payer(s))
• Uses exceptional organization, written, and verbal communication skills to produce detailed documentation of research and actions taken on claims
• Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies

Schedule:

• 8 hour shift; regular business hours
• Monday -Friday

Qualifications:

• Highschool Diploma or equivalent (required); Associates or Bachelor's degree (preferred)
• Proficiency in Microsoft Office tools including Excel, Word, and Outlook (required)
• Experience working with Medicaid and Medicare payers (required)
• Healthcare revenue cycle, medical billing, and collections experience (3-5 years+) preferred

Here is what you can expect when you join our Village:

• A "community first, company second;" a 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

What We'll Provide:

More than just pay, our DaVita Rewards package connects teammates to what matters most.  Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment.  Below are some of our benefit offerings.

• Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out
• Support for you and your family: Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave and more
• Professional development programs: 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.

At DaVita, we strive to be a community first and a company second.  We want all teammates to experience DaVita as "a place where I belong."  Our goal is to embed Diversity & Belonging into everything we do in our Village, so that it becomes part of who we are.  We are proud to be an equal opportunity workplace and an affirmative action employer.  As such, individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic.

Salary/ Wage Range:

Salary Wage Range:

Compensation for the role will depend on a number of factors, including a candidate's qualifications, skills, competencies and experience and may fall outside of the range shown.  DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits.  Learn more at https://careers.davita.com/benefits 

Work Environment:

Level III – Moderate noise (e.g., business office with computers or printers, light traffic).  No required tasks involve greater exposure to blood, body fluids or tissues than would be encountered by a visitor.  The normal work routine involves no exposure to blood, body fluids or other hazardous conditions.

Visual Demand:

Vision adequate to perform the essential duties/responsibilities of position.

May be required to demonstrate the ability to differentiate colors on a test strip.

Physical Demand:

Physical requirements can vary.  These must be reviewed with management.  However, in general, the position requires the following activities:

Ability to lift minimum of 5 lbs to a max of 50 lbs unassisted and able to stand, sit, stoop, walk, stretch, reach, and use full range of body motions.

Manual dexterity as required for specific equipment and ability to use computer keyboard and peripherals.

Language Skills:

Fluent in the written and verbal skills necessary to successfully perform the essential functions, duties, and responsibilities of the position.

ADA:

DaVita provides reasonable accommodations to enable otherwise qualified individuals with disabilities to perform the essential Physical and/or Mental functions of a position.

Applications are accepted on an ongoing basis.

Salary/ Wage Range

Compensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience and may fall outside of the range shown. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits