DaVita Careers

Payor Contracting Specialist

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Position Description

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
o    Document actions in database
o    Review requests for approval, impact, issues, and take appropriate action including consultation with legal
o    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:
o    Complete Quality Assurance assessments of various Payor Contracting functions
o    Provide feedback to team and/or report metrics to leadership to as needed
o    Assist with development and maintenance of process documents
o    Assist with initiatives to automate aspects of Quality Assurance
o    Assist with teammate education and training surrounding Quality Assurance as needed
·    Perform other duties and responsibilities as assigned including but not limited to:
o    Work overtime with little or no notice as needed
o    Attend team meetings, phone conferences, and training as needed
o    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.    

Qualifications

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

 
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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WARNING: Job Recruitment Scam Notice
Please note that DaVita Careers has been made aware of a phishing, job recruitment scam in which third parties are fraudulently representing themselves as recruiters of our company.  These scammers are posting fake DaVita job openings and communicating with job candidates in an effort to obtain personal information and money.  Please follow link to learn more about this scam.

Learn More: http://careers.davita.com/JobRecruitmentScamNotice 

 

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 age, 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.

 

DaVita will consider qualified applicants who have criminal histories in a manner consistent with the law.

Position Summary

  • Job Title: Payor Contracting Specialist
  • Job Function: Other - Corporate Office
  • Location: 32275 32nd Ave S, Federal Way, Washington