Revenue Lead, ROPS

DaVita Kidney Care

101d • $27 - $34

About The Position

This position researches and resolves high complexity Insurance coverage discrepancies according to DaVita policies and procedures and compliance with federal and state billing regulations. This position also provides ongoing training and guidance for Revenue Specialist teammates, and performs data trending analysis, quality assurance reviews and review of key metrics.

Requirements

• High School diploma or equivalent required.
• Two to four years’ experience in healthcare reimbursement and revenue cycle management.
• Experience leading a team or project preferred.
• Intermediate proficiency in MS Excel, Word and PowerPoint.

Responsibilities

• Review weekly and monthly key metrics to identify trends or areas of focus; work with Management to develop, document, and implement action plans to address issues.
• Identify payer trends and or root cause of denials or spikes in verification requests; take appropriate steps to resolve and/or escalate issues to ensure accuracy and reduce need for re-verifications.
• Identify and interpret policies related to exceptions.
• Determine and apply appropriate business action in absence of policies or in cases of ambiguity.
• Escalate issues as needed; provide recommendations.
• Act as resource for teammate’s questions and assist with issues of focus and problematic payer issues onboard and coach new teammates.
• Identify training opportunities to improve individual and team performance; perform one-on-one and group training as needed.
• Recommend changes on registration teams, tools, policies and procedures.
• Perform all close reconciliation approvals and related activities to ensure timely coverage change reviews.
• Serve as a subject matter expert for close.
• Conduct quality assurance reviews of work output and provide feedback to teammates and management; offer suggestions for improvement.
• Ability to manage and lead multiple projects, meet deadlines, and adjust priorities appropriately in a high paced work environment.
• Support department initiatives.
• Stay abreast of policy updates that impact coverage setting for regulatory and commercial payors.
• Maintain confidentiality of all patient, teammate, and company information in accordance with HIPPA regulations and DaVita policies.
• Attend team meetings, phone conferences, and training as needed.
• Host or Co-host team meetings.
• Collaborate with supervisor on team-building.
• Embrace the DaVita culture by actively participating in village and neighborhood initiatives.

Benefits

• 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.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees