Specialist I, Denials

4 weeks ago

Kolkata, India LAB Total Renal Laboratories, Inc Full time

Description

GENERAL PURPOSE OF THE JOB

The Specialist I, Denials (Lab) is responsible for the review and resolution of denied claims due to benefit issues, verifying applicable insurance coverage for multiple states, and determining correct coordination of benefits information. Applies the knowledge and skills to complete a wide range of tasks at a level which meets department standards and ensures goals and objectives are achieved. Ensures claim adjustments are applied using appropriate payer terms based on department guidelines. Adheres to DaVita policies including corporate compliance and all rules and regulations under the applicable local, state, and federal agencies and accrediting bodies. This position reports tot eh Supervisor, Revenue Operations (Lab).

ESSENTIAL DUTIES & RESPONSIBLITIES

Initiate follow-up of all denied claims due to benefit related issues with the insurance payer to ensure proper reimbursement on claims. Researches, appeals, resolves claim denials with the payer based on payer terms. Manages payer authorization process by obtaining authorizations from payers as required. Verify all applicable insurances with payers including patient eligibility and all associated benefits related to outpatient kidney dialysis laboratory testing. Determine Coordination of benefits as required. Validates and requests insurance changes through the A/R system as required during the denial resolution process.

About DaVita Laboratories

DaVita Labs is a state-of-the-art clinical laboratory delivering timely, accurate lab results focused primarily on kidney care with a relentless commitment to quality. We serve more than 180,000 patients and perform 52 million renal tests annually. We make a difference. We enjoy what we do. Our teammates are best in class professionals who enjoy a challenging yet rewarding work environment where fun and hard work intermingle every day. From our laboratory professionals to our support roles, DaVita labs not only offers a career to fit each individual, it provides a community and a place to call home. As a labs teammate, you become a member of our community and you also become a citizen of something bigger, something great, and something unique - the DaVita Village. With the backing of the overall DaVita brand, we are on an exciting trajectory.

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.

Want to make an impact in Healthcare? Through science, technology, quality and education, we are committed to expanding discovery and empowering lives. This empowerment comes in many forms. From our laboratory professionals to our support roles, DaVita labs not only offers a career to fit each individual, it provides a community and place to call home. Join us as we pursue our vision "To Build the Greatest Healthcare Community the World has Ever Seen."
 

What We’ll Provide:

More than just pay, our DaVita Rewards package connects teammates to what matters most. Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offerings.

Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out Support for you and your family: Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave and more Professional development programs: DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita’s online training platform StarLearning.

At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed Diversity & Belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and an affirmative action employer. As such, individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic.

Applications are accepted on an ongoing basis. Salary/ Wage Range Compensation for the role will depend on a number of factors, including a candidate’s qualifications, skills, competencies and experience and may fall outside of the range shown. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at

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