Revenue Lead, ROPS
About The Position
The Revenue Lead, ROPS researches and resolves high-complexity insurance coverage discrepancies in accordance with DaVita policies and procedures and applicable federal and state billing regulations. The role provides ongoing training and guidance to Revenue Specialist teammates and conducts data-trending analysis, quality assurance reviews, and review of key metrics. It has no supervisory responsibilities. The position reviews weekly and monthly metrics, identifies payer trends and denial root causes, applies policies and appropriate business actions where guidance is ambiguous, and escalates issues with recommendations as needed. It also supports teammates, onboards and coaches new team members, conducts training, recommends improvements to registration teams and processes, and performs close reconciliation approvals and related coverage-change reviews. The Revenue Lead supports department initiatives and projects, maintains confidentiality, follows DaVita and department policies, participates in team and community activities, and may travel less than 5%. Overtime may be required.
Requirements
- High school diploma or equivalent.
- Two to four years of experience in healthcare reimbursement and revenue cycle management.
- Intermediate proficiency in MS Excel, Word, and PowerPoint.
- Strong analytical skills, follow-through, and ability to identify underlying assumptions through probing, questioning, listening, and problem-solving.
- Ability to interact positively with all levels of the company.
- Ability to manage multiple projects, meet deadlines, and adjust priorities in a fast-paced work environment.
- Commitment to DaVita’s values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment, and Fun, demonstrated in interactions with patients, teammates, management, physicians, and vendors.
Nice To Haves
- Experience leading a team or project.
Responsibilities
- Review weekly and monthly key metrics to identify trends or areas of focus, and work with Management to develop, document, and implement action plans.
- Identify payer trends and root causes of denials or increases in verification requests; resolve or escalate issues to improve accuracy and reduce re-verifications.
- Identify and interpret policies related to exceptions and determine appropriate business actions when policies are absent or ambiguous.
- Escalate issues as needed and provide recommendations.
- Serve as a resource for teammate questions and assist with focus areas and problematic payer issues.
- Onboard and coach new teammates.
- Identify training opportunities and conduct one-on-one and group training as needed.
- Recommend changes to registration teams, tools, policies, and procedures.
- Perform close reconciliation approvals and related activities to ensure timely coverage-change reviews; serve as a subject matter expert for close.
- Conduct quality assurance reviews and provide feedback and improvement suggestions to teammates and management.
- Manage and lead multiple projects, meet deadlines, adjust priorities, and support department initiatives.
- Stay current on policy updates affecting coverage settings for regulatory and commercial payors.
- Maintain confidentiality of patient, teammate, and company information in accordance with HIPAA regulations and DaVita policies.
- Follow DaVita teammate, employment, safety, security, department, and company policies and procedures.
- Maintain consistent, regular, and punctual attendance; attend team meetings, phone conferences, and training as needed; host or co-host team meetings.
- Collaborate with the supervisor on team-building and participate in village and neighborhood initiatives while demonstrating DaVita’s core values.
- Perform other duties and responsibilities as assigned.
- Travel less than 5%; overtime may be required to complete tasks and duties.
Benefits
- Comprehensive medical, dental, and vision benefits.
- 401(k) match.
- Paid time off and PTO cash out.
- Family resources and EAP counseling sessions.
- Access to Headspace.
- Backup child and elder care.
- Maternity and paternity leave.
- Professional development programs and on-demand virtual leadership and development courses through StarLearning.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
