Revenue Lead, ROPS
About The Position
The Revenue Lead, ROPS position is responsible for reviewing key metrics, identifying trends, and developing action plans to address issues in healthcare reimbursement and revenue cycle management. This role involves identifying payer trends, resolving billing or claim exceptions, and interpreting related policies. The Lead will act as a resource for teammates, train new employees, and recommend changes to collection teams, tools, policies, and procedures. A key responsibility includes performing close reconciliation approvals and serving as a subject matter expert for the close process, as well as reviewing and approving adjustments and claims appeals. The position also requires conducting quality assurance reviews, managing multiple projects, and staying updated on relevant laws and changes. Strong analytical skills, problem-solving abilities, and positive interaction with all company levels are essential. Maintaining patient, teammate, and company information confidentiality in accordance with HIPAA and DaVita policies is also a critical aspect of this role. The position requires consistent attendance, with potential for overtime, and active participation in team meetings and DaVita culture initiatives, demonstrating core values.
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
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
