Revenue Lead, ROPS
About The Position
The Revenue Lead researches and resolves high-complexity collection account balances in accordance with DaVita policies and federal and state billing regulations. The role provides ongoing training and guidance to Specialist Patient Account teammates and performs data-trending analysis, quality assurance reviews, and key-metric reviews. It also serves as a subject matter expert for close reconciliation and supports timely submission of primary, secondary, and tertiary insurance claims. The position works with management to identify trends, resolve billing and payer issues, and develop action plans. It reviews teammate work, approves adjustments and appeals, offers feedback, and recommends improvements to collection teams, tools, policies, and procedures. The role requires analytical problem-solving, collaboration across company levels, confidentiality, and the ability to manage projects and shifting priorities in a fast-paced environment. Less than 5% travel is required; overtime may be required.
Requirements
- High school diploma or equivalent.
- Intermediate proficiency in Microsoft Excel, Word, and PowerPoint.
- Strong analytical skills, follow-through, and problem-solving ability, including the ability to probe, question, listen, and seek underlying assumptions.
- 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.
- Ability to demonstrate DaVita’s values positively and proactively in interactions with patients, teammates, management, physicians, and vendors.
- Ability to build collaborative relationships, seek opportunities to work effectively with others, use conflict-resolution skills, act consistently with team values, keep commitments, and provide service excellence.
Nice To Haves
- Two to four years of experience in healthcare reimbursement and revenue cycle management.
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 billing or claim exceptions; resolve or escalate issues to minimize bad debt.
- Identify and interpret policies related to exceptions, and determine appropriate business action 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.
- Train new teammates and identify training opportunities to improve individual and team performance; conduct one-on-one and group training as needed.
- Recommend changes to collection teams, tools, policies, and procedures.
- Perform close reconciliation approvals and related activities to support 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 Specialists of Patient Accounts.
- Conduct quality assurance reviews of work output 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 changes to ESRD and Medicare Secondary Provider laws.
- Maintain confidentiality of patient, teammate, and company information in accordance with HIPAA regulations and DaVita policies.
- Follow the DaVita teammate handbook, employment policies, safety and security procedures, and department or company procedures.
- Maintain consistent, regular, and punctual attendance; attend team meetings, phone conferences, and training as needed.
- Participate in village and neighborhood initiatives and demonstrate DaVita’s core values.
- Perform other duties and responsibilities as assigned.
Benefits
- Medical, dental, and vision coverage.
- 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
