Insurance Counselor I (ROPS)

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 resolvedassistsin securing secondary coverage for Medicare No Secondary patients andassistsunder-insured and uninsured/pending coverage patients with eligibility and/or coverage options. Position providesaccurateandtimelypatient revenue and treatment trend reporting to the Group insurance Manager and operations teams that it supports.

ESSENTIAL DUTIES AND RESPONSIBILITIES

The following duties and responsibilitiesgenerally reflectthe expectations of this position but are not intended to be all inclusive.

Insurance Counseling

• Act as a liaison between patients facility teammates billingofficeand the corporate office to resolve patient insurance issues and/or concerns

• Identifyresolveor escalate issues asappropriate forprompt and effective resolution

• Proactively build relationships with patients

• Proactively review patient lists with Facility Administrators and teammates toidentifypotential 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 todetermineif payment or payment arrangements arean option

• Help patients find potential payment plan options

• Help patients obtain as close to 100% insurance coverage for patients as possible by educating on 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

• Identifyany DaVita programs that would help apatientsfinancialsituation(i.e. Patient Financial Evaluations)

• Assistpatients and Social Workers with applications for Charitable Assistance as necessary

• Partner with Social Workers tomaintainawareness of patient insurance questions

Patient Interaction

• Assist Medicare patients with securing secondary insurance coverage

• Assistpatients and/or Social Workers as necessary todetermineif cash repayment isan option

• Research commercial patients financial issues and insurance options and educate on what options are available for their specific situation.

• Reviewadditionalinsurance 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

• Proactively manage insurance terminations or changes

• Identifyregistration 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

Reporting

• Provide monthly reporting and analysis on key metrics related to patient education and advocacy to senior management

• Compile monthly operations reviews on assigned patient portfolio

• Participate in scheduledSAMscalls 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 asappropriate onInsurance Management practices

• Shadow new hires to mentor and to provide training as needed

• Telephonic Communication 100%

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-beingand your future.

• Dedication above all tocaring for patients suffering from chronic kidney failure across the nation.

MINIMUM QUALIFICATIONS

(Education licenses certifications and experienceto fulfill the essential duties include computer skills as)

• High school diploma or equivalent required

• Minimum of two (2) years experience working with Medicare and Medicaid insurance as well as commercial insurance plans and benefits (PPO HMO POSEPO Indemnity)

• Minimum of two (2) years experience in a healthcare organization working with clinical staff and patients preferred

• Intermediate computer skills andproficiencyin MS Word Excel PowerPoint and Outlook

• Bilingual/Spanish preferred