Revenue Lead, ROPS

DaVita Kidney Care

7d • $23 - $31 • Onsite

About The Position

The Revenue Lead, ROPS position is responsible for reviewing key metrics, identifying trends, and developing action plans to address issues. This role involves identifying payer trends and root causes of billing or claim exceptions, interpreting policies, and determining appropriate business actions. The Revenue Lead will also act as a resource for teammates, train new team members, and recommend changes to collection teams, tools, policies, and procedures. Additionally, this role involves approving close reconciliations, adjustments, and claims appeals, conducting quality assurance reviews, and managing multiple projects. The position requires staying updated on ESRD and Medicare Secondary Provider laws, possessing strong analytical and problem-solving skills, and interacting positively with all levels of the company while maintaining confidentiality.

Requirements

• High School diploma or equivalent required
• Intermediate proficiency in MS Excel, Word and PowerPoint
• Commitment to DaVita’s values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment and Fun with ability to demonstrate those positively and proactively to patients, teammates, management, physicians, and/or vendors (Village Service Partners) in everyday performance and interactions

Nice To Haves

• Two to four years’ experience in healthcare reimbursement and revenue cycle management preferred

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 billing or claim exceptions; take appropriate steps to resolve and/or escalate issues to minimize bad debt
• 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
• Train new teammates
• Identify training opportunities to improve individual and team performance; perform one-on-one and group training as needed
• Recommend changes on collection teams, tools, policies and procedures
• Perform all close reconciliation approvals and related activities to ensure timely submission of primary, secondary and tertiary insurance claims. Serve as a subject matter expert for close
• Review and approve adjustments and claims appeals submitted by Specialist of Patient Accounts
• 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 changes to ESRD and Medicare Secondary Provider laws and changes
• Strong analytical skills, follow through; with the ability to seek underlying assumptions through probing, questioning, listening, and problem solving
• Ability to interact positively with all levels of the company
• Maintain confidentiality of all patient, teammate, and company information in accordance with HIPPA regulations and DaVita policies
• Know, understand, and follow DaVita teammate handbook, employment policies, safety and security policy and procedures
• Consistent, regular and punctual attendance as scheduled
• Overtime may be required to ensure timely completion of tasks and required duties
• Attend team meetings, phone conferences, and training as needed
• Know, understand, and follow department or company procedures
• Embrace the DaVita culture by actively participating in village and neighborhood initiatives
• Demonstrate DaVita’s core values in all aspects of your role

Benefits

• Medical, dental, vision, 401(k) match, paid time off, PTO cash out
• Family resources, EAP counseling sessions, Headspace®, backup child and elder care, maternity/paternity leave

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED