DaVita Careers

Claim Formatting Analyst

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Position Description

Responsible for compliant claim formatting and successful delivery to DaVita Kidney Care’s claims clearing house.  Scope includes electronic billing for payers using 837 transactions as well as paper billed payers.
Day-to-day tasks include researching and understanding complex industry and payer requirements, executing changes, QA, and testing for: 1) bill templates in the billing systems and 2) bridge routines, print commands and mapping tables in the claim management software.
Essential Duties and Responsibilities
  • Supports all Setup teams and overall ROPS by serving as experts on claim formatting requirements (X12, NUBC, NUCC, etc.)
  • Researches, vets and documents payer and industry requirements related to claim formatting
  • Performs any necessary testing and changes to claim formats including 837 transactions and paper claim formats
  • Performs any necessary testing and changes to ePremis bridge routines, print commands, mapping tables etc.
  • Completes quality assurance for changes to ePremis bridge routines, print commands, mapping tables etc.
  • Assist the team lead in streamlining and improving processes by providing feedback and writing updated policy and procedures
  • Participate in testing of NS/Focus/ePremis releases as needed
  • Documents QA results thoroughly and ensures that all back up documentation is complete and accurate
  • Monitors changes to alert Risk Management to ensure adherence with relevant ROPS and Compliance policies and procedures (including the over-payment policy)
  • Leads and actively engages in meetings and group discussions to move issues forward
  • Supports the design, implementation, and management of team processes to continuously improve performance and meet overall objectives
  • Collaborates with cross-functional teams to develop creative solutions to complex system setup issues
  • Serves as Service Excellence point of contact for partners throughout Revenue Operations
  • Prepares ad hoc and recurring reporting 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.    


Minimum Qualifications:
  • High School diploma (or equivalent) required
  • Bachelor’s degree in healthcare or related field preferred. Or a minimum of three (3) years of experience in healthcare, revenue cycle and/or claim formatting required
  • Intermediate proficiency in Internet and MS Office environments (Word, PowerPoint, Access, Excel, and Outlook) required, as well as the ability and desire to advance technically
  • Ability and desire to learn advanced communication skills required (conveying complex and abstract concepts clearly and succinctly across different audiences)
  • Minimum of one (1 year) experience working in a high responsibility environment requiring self-direction and bias toward action preferred
  • Minimum of one (1 year) experience managing multiple projects, meeting deadlines, and adjusting priorities appropriately in an evolving work environment with shifting time frames
  • Demonstrated understanding of HIPAA 837 transaction structure required
  • Experience building test scripts preferred, ability to learn required
  • Understanding of programming logic preferred
  • Experience in SQL query building 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.
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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: Claim Formatting Analyst
  • Job Function: Other - Corporate Office
  • Location: 2476 Swedesford Rd, STE 150, Malvern, Pennsylvania