DaVita is currently seeking a highly talented Credentialing Specialist II located in our Federal Way Central Business Office!
GENERAL PURPOSE OF THE JOB
This position ensures timely and accurate response to requests for facility credentialing from contracted insurance payors and ensures the confirmation of a facility’s addition to the insurance payor’s network. Experienced Credentialing Specialists may have role expanded to perform alternative Quality Assurance tasks.
ESSENTIAL DUTIES AND RESPONSIBILITIES
The following duties and responsibilities generally reflect the expectations of this position but are not intended to be all-inclusive
- Process initial credentialing, re-credentialing, and facility addition requests
- Provide status updates, document actions in database
- Review requests for approval, impact, issues, and take appropriate action including consultation with legal
- Provide status updates to stakeholders (reporting)Complete applications and assemble documentation as required by the Health Plan
- Obtain network participation status from insurance payors
- Complete regular audits of workflow to make updates or corrections as needed
- Oversee initial and complex credentialing requirements discussions with entities and agencies both internal and external
- Experienced Credentialing Specialists may perform alternate tasks such as: complete Quality Assurance assessments of various Payor Contracting functions, provide feedback to team and/or report metrics to leadership to as needed, assist with development and maintenance of process documents, assist with initiatives to automate aspects of Quality Assurance, assist with teammate education and training surrounding Quality Assurance as needed
- 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
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.
Education, licenses, certifications, and experience required to fulfill the essential duties, include computer skills as required.
- High school diploma or equivalent required
- 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
ESSENTIAL BEHAVIORS, SKILLS, AND ATTITUDES REQUIRED FOR SUCCESS IN THIS POSITION
- Commitment to DaVita’s values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment and Fun with ability to demonstrate those positively and proactively to patients, teammates, management, physicians, and/or vendors (Village Service Partners) in everyday performance and interactions
- Strong written, verbal, and interpersonal communications skills including ability to listen attentively and to communicate information clearly and effectively
- Demonstrated ability to work in a team, facilitate effective team interactions, and to foster a positive work environment; willingness to assist teammates in order to achieve departmental goals
- Demonstrated strengths in organizational, attention-to-detail, follow-through, analytical, reasoning, critical thinking, and problem-solving skills
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.
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.