Specialist II, Contract Operations

This is a fully remote position, open to applicants in Alabama, +4 more states.

📋 Description

• Conduct precise and prompt reviews of contracts focusing on Best Demonstrated Performance language, checklists, codes, rates, and operational credentialing language.

• Independently investigate and resolve intricate network and claims issues by collaborating with Credentialing Specialists and Negotiation teams.

• Evaluate the root causes of delays or denials using tools such as the A3 worksheet format.

• Analyze complex situations and communicate effectively with leadership utilizing the SBAR (Situation, Background, Assessment, Recommendation) format.

• Ensure data accuracy across multiple systems, including Orion, CLM, COR, Salesforce, and IBM-based data systems.

• Generate data for weekly reports, encompassing task categories, email volume, out-of-SLA task assistance, and escalation tracking.

• Achieve and maintain an average Quality Assurance (QA) score of 95% or above concerning critical errors.

• Foster and sustain robust professional relationships with external payor contacts to enhance processing efficiency.

• Work collaboratively with internal "Partners" to proactively address account issues.

• Handle an exceptionally high volume of work, ensuring email inbox counts remain below 40 and responding to requests within 1-2 business days.

⛳️ Requirements

• A high school diploma or equivalent is required; an Associate’s or Bachelor’s degree is preferred.

• At least 2 years of experience in high-volume research, Customer Accounts management, or complex administrative resolution work.

• A proven history of exceptional performance in a production-driven environment.

• Advanced Excel skills are required: Must demonstrate experience with formula writing (e.g., complex IF statements, VLOOKUP, mail merge integration, conditional formatting).

• Strong proficiency in Microsoft Outlook (handling high email volume), Word, PowerPoint, and SharePoint.

• Preferred experience with Salesforce or database management systems.

🏝️ Benefits

• Comprehensive benefits package: Medical, dental, vision, 401(k) match, paid time off, and PTO cash out.

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

• Professional development opportunities: DaVita provides a variety of programs to assist high performers in advancing their careers, along with on-demand virtual leadership and development courses through DaVita’s online training platform, StarLearning.