GENERAL PURPOSE OF THE JOB <?xml:namespace prefix = "o" />
This position provides guidance and information to patients on insurance and the implications of different insurance options to allow patients to make informed insurance decisions. This position ensures that commercial patients’ insurance questions are addressed and resolved, assists in securing secondary coverage for Medicare No Secondary patients, and assists under-insured and uninsured/pending coverage patients with eligibility and/or coverage options. Position provides accurate and timely patient, revenue, and treatment trend reporting to the Group insurance Manager and operations teams that it supports.
ESSENTIAL DUTIES AND RESPONSIBILITIES
The following duties and responsibilities generally reflect the expectations of this position but are not intended to be all inclusive.
- Act as a liaison between patients, facility teammates, billing office and the corporate office to resolve patient insurance issues and/or concerns
- Identify, resolve or escalate issues as appropriate for prompt and effective resolution
- Proactively build relationships with patients
- Proactively review patient lists with Facility Administrators and teammates to identify potential patient insurance issues
- Proactively build relationships with clinical and regional resources to emphasize and integrate Insurance Management priorities
- Support education on and completion of Patient Financial Evaluations to determine if payment or payment arrangements are an option
- Help patients find potential payment plan options
- Obtain as close to 100% insurance coverage for patients as possible by exploring all avenues and coverages
- Ensure that patients who qualify have 100% coverage (excluding non-compliant patients)
- Support patient collection activities as necessary by educating patients about balances due and encouraging them to work with the billing office to resolve
- Identify any DaVita programs that would help (i.e. Patient Financial Evaluations)
- Assist Social Workers with completion of AKF applications as necessary
- Partner with Social Workers to maintain awareness of patient insurance questions
- Assist Medicare patients with securing secondary insurance coverage
- Assist patients and/or Social Workers as necessary to determine if cash repayment is an option
- Research commercial patients’ financial issues and insurance options and assist patients in retaining commercial insurance coverage
- Review additional insurance options for primary and/or secondary coverage
- Provide high-level of customer service to ensure patient questions or issues are addressed effectively
- Provide information to patients to help them find and/or secure all options for insurance coverage
Facilitate Conference calls
- Facilitate weekly team calls partnering with facility and billing office teammates to ensure smooth registration process
- Proactively manage insurance terminations or changes
- Identify registration process improvement opportunities
- Brainstorm and help resolve incomplete or problematic registration challenges
- Manage and update tracking tools as appropriate
- Review trends with team and operational leadership
- Provide monthly reporting and analysis on key metrics related to patient growth and retention to senior management
- Compile monthly operations reviews on assigned patient portfolio
- Participate in scheduled SAMs calls to review patient portfolio with designated facility teammate
Other duties and responsibilities as assigned including but not limited to:
- Attend team meetings, phone conferences, and training as needed
- Know, understand, and follow teammate guidelines, employment policies, and department or company procedures
- Participate as requested in special projects and Insurance Management Team initiatives
- Mentor team members as appropriate on Insurance Management practices
- Shadow new hires to mentor and to provide training as needed
- Travel Required: up to 85% within assigned area
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.