Job description
The Specialist, Payor Partnerships (Lab) read, interpret and administer the terms of the contract portfolio that health insurance companies have in place with DaVita Labs and DaVita Kidney Care to ensure contractual terms are accurately reflected in the billing system. This position manages relationships with a wide variety of payors. Within these relationships, this position is responsible for securing and maintaining in-network status through credentialing, contract negotiation and implementing payor contracts. This position performs surveillance of all federal and state laws and regulations pertaining to the reimbursement of clinical laboratory services to ensure compliant billing practices. This position reports to the Manager, Payor Partnerships (Lab).
Essential Functions:
Complete and monitor provider credentialing applications, negotiate payor contracts and single patient agreements on behalf of the lab
Process payor correspondences and complete monitoring of rules and regulations from governmental entities with the use of MediRegs and various sources
Coordinates with Lab ROPS and DKC Payor Partnerships teammates as needed to resolve contract issues, trouble shoot problematic payors, address contractual discrepancies, and provide recommendations and redlines for lab terms within proposed contracts.
Read and interpret new, amended, renegotiated payor contracts and single patient agreements in preparation for system implementation
Coordinate with Lab Finance Systems and Lab Billing to setup payors in the billing
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.
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 https://careers.davita.com/benefits
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