Revenue Lead, ROPS
About The Position
The Revenue Lead, ROPS researches and resolves high-complexity insurance coverage discrepancies in accordance with DaVita policies and federal and state billing regulations. The role supports Revenue Specialist teammates through training and guidance, data trending analysis, quality assurance reviews, and monitoring key metrics. It has no supervisory responsibilities. The position reviews weekly and monthly metrics, identifies payer trends and root causes of denials or verification spikes, interprets policies and exceptions, and recommends or implements actions to resolve issues. The Revenue Lead serves as a resource for teammates, onboards and coaches new teammates, conducts training, performs close reconciliation approvals, and reviews work quality. The role also supports department initiatives and projects, maintains confidentiality, follows company and department policies, and participates in team and DaVita community activities. Less than 5% travel is required; overtime may be required to complete tasks.
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 and follow-through, including the ability to probe, question, listen, and solve problems.
- Ability to manage multiple projects, meet deadlines, and adjust priorities in a fast-paced work environment.
- Ability to interact positively with all levels of the company.
- Commitment to and ability to demonstrate DaVita’s values: Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment, and Fun.
Nice To Haves
- Experience leading a team or project.
Responsibilities
- Review weekly and monthly key metrics to identify trends and focus areas, and work with Management to develop, document, and implement action plans.
- Identify payer trends and root causes of denials or spikes in verification requests; take appropriate steps to resolve or escalate issues to ensure 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.
- Act as a resource for teammates, answering questions and assisting 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 support timely coverage change reviews; serve as a subject matter expert for close.
- Conduct quality assurance reviews of work and provide feedback and suggestions for improvement to teammates and management.
- Manage and lead multiple projects, meet deadlines, adjust priorities, and support department initiatives.
- Stay current on policy updates affecting coverage setting for regulatory and commercial payors.
- Maintain confidentiality of patient, teammate, and company information in accordance with HIPAA regulations and DaVita policies.
- Follow DaVita teammate handbook, employment, safety, security, department, and company policies and procedures.
- Maintain consistent, regular, and punctual attendance; attend meetings, phone conferences, and training as needed; host or co-host team meetings and collaborate with a supervisor on team-building.
- Participate in village and neighborhood initiatives and demonstrate DaVita’s core values.
- Travel less than 5% as required; overtime may be required to ensure timely completion of tasks.
Benefits
- Medical insurance
- Dental insurance
- Vision insurance
- 401(k) match
- Paid time off
- PTO cash out
- Family resources
- 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
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
