Senior Business Analyst, ROPS

📋 Description

• Initiate and/or maintain continuous communication with facilities to guarantee the prompt and precise acquisition of each patient's insurance coverage details.

• Input insurance information into the billing system.

• Validate patient insurance with payers, including eligibility and benefits concerning outpatient kidney dialysis.

• Accurately update Patient Registration and related systems as necessary.

• Collaborate closely with Patient Referral Coordinators (PRC) to secure the required documentation for successful patient registration.

• Work in partnership with the facility and Insurance Management Team to address incomplete registrations.

• Analyze registration denials received to identify the root cause.

• Rectify patient account errors that lead to registration denials.

• Assist in identifying process improvements to avert failed registrations.

• Determine Coordination of Benefits as needed, ensuring current patient account information is maintained at all times.

• Follow up as needed to confirm insurance changes are verified and the line of coverage is reset.

• Submit internal requests, including but not limited to RCUs, SMARTFORMS, PCS Inquiries, SPA Requests, etc., to ensure precise and prompt claims submission to the appropriate payer.

• Complete all ancillary reports and assigned projects within set timeframes.

• Support Patient Account Representatives and other ROPS teammates as required.

• Uphold the confidentiality of all company and patient information in compliance with HIPAA regulations and DaVita policies.

• Perform other duties and responsibilities as assigned, including but not limited to: working overtime with little or no notice as needed; attending team meetings, phone conferences, and training as required; and knowing, understanding, and following teammate guidelines, employment policies, and department or company procedures.

⛳️ Requirements

• High school diploma or equivalent is required.

• A minimum of three (3) years of healthcare reimbursement experience is preferred; experience in admissions, billing, and collections is also preferred.

• Demonstrated understanding of insurance rules, regulations, and Coordination of Benefits for federal, state, and managed care payers across multiple states is preferred.

• Basic computer skills and proficiency in MS Word, Excel, and Outlook are required.

🏝️ Benefits

• Comprehensive benefits including medical, dental, vision, 401(k) match, paid time off, and PTO cash out.

• Support for you and your family, including family resources, EAP counseling sessions, access to Headspace®, backup child and elder care, maternity/paternity leave, and more.

• Professional development programs: DaVita provides various programs to assist strong performers in advancing their careers and offers on-demand virtual leadership and development courses via DaVita’s online training platform, StarLearning.