Revenue Lead, ROPS

DaVita • Jackson, MS

5d • Onsite

About The Position

The Revenue Lead, ROPS 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 working with management to resolve billing and claim exceptions, interpreting policies, and acting as a resource for teammates. The position also includes training new teammates, recommending process improvements, and performing close reconciliation approvals to ensure timely claim submissions. Additionally, the Revenue Lead will conduct quality assurance reviews, manage multiple projects, and stay updated on relevant healthcare laws. Maintaining patient and company confidentiality in accordance with HIPAA and DaVita policies is crucial. The role also requires consistent attendance, potential overtime, and active participation in team meetings and company culture initiatives.

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.

Nice To Haves

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

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 a 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.
• 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.
• Demonstrate strong analytical skills, follow through; with the ability to seek underlying assumptions through probing, questioning, listening, and problem solving.
• 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
• Professional development programs
• 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