DaVita Careers

Credentialing Specialist II

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Position Description

This position supports the primary function of the credentialing team to complete credentialing with contracted insurance payors.  The role offers assistance in the management of specific workflow duties which may include but is not limited to: timely and accurate processing of incoming mail, credentialing document requests, reporting and auditing, and following up with payors to confirm a facility’s addition to the insurance’s network.

 

Supervisory Responsibilities:  No, this position reports to team Supervisor

 

Document Support (As Assigned):

  • Obtains and validates CMS and State Surveys, State Licenses, Business Licenses, Medicare Certifications, Medicaid Certifications, CLIAs and Other Documentation as necessary.
  • Maintains Document Inventories and ensure accuracy and completeness.
  • Runs and manages weekly “Missing Documents Report” and follow up as needed.
  • Runs daily batch matching Inventories to FACTS in order to update missing document statuses.
  • Updates Encyclopedia continuously (where managed by DFC) to ensure information is current and complete.
  • Responds to urgent requests from Credentialing team to ensure timely Credentialing is completed.
  • Maintains working relationships with Regulatory Affairs, License & Certification and Facility Administrators.
  • Audits reports and document data sources to monitor accuracy/quality.

Workflow Support (As Assigned):

  • Obtains network participation status from insurance payors and update records in various systems.
  • Documents workflow actions in appropriate databases.
  • Adheres to escalation processes and coordinate communications with specialists for resolution.
  • Runs reports and audits as required.
  • Assists and/or processes incoming hard copy mail, efaxes, email and letter handling projects within Payor Contracting and route to appropriate parties both timely and accurately.
  • Assists with process updates or modifications to procedure as needed.
  • Other duties as assigned.

Here is what you can expect when you join our Village: 
  • A "community first, company second" 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.    

Qualifications

  • High school diploma or equivalent preferred
  • Minimum of six (6) months’ administrative or clerical business office experience required
  • Minimum of six (6) months’ experience in licensing, healthcare, or insurance strongly preferred
  • Certification or training in related area strongly preferred
  • Basic computer skills and proficiency in MS Word, Excel, and Outlook required; basic proficiency in MS Access and PowerPoint preferred
  • Ability to manage confidential information and/or issues using discretion and judgment required

Join us as we pursue our vision "To Build the Greatest Healthcare Community the World has Ever Seen."
 
Why wait? Explore a career with DaVita today.
 
Go to http://careers.davita.com to learn more or apply. 
  
To learn more about our Village and the world of dialysis, click here.

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DaVita is an equal opportunity/affirmative action employer.  As such, DaVita makes hiring decisions solely on the basis of qualifications and experience, and without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, disability or protected veteran status. 

 

We maintain a drug-free workplace and perform pre-employment substance abuse testing and background verification checks.

Position Summary

  • Job Title: Credentialing Specialist II
  • Job Function: Billing / Collections / Insurance
  • Location: Federal Way, Washington