Revenue Lead, ROPS

DaVita•Federal Way, WA

25d•$28 - $34

About The Position

This position researches and resolves high complexity collection account balances 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 preferred
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

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 claim appeal 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
Less than 5% travel required