Revenue Specialist III (ROPS)
About The Position
DaVita is seeking a Revenue Specialist for its billing systems setup team in the Revenue Operations Department. The role supports revenue cycle operations by analyzing and maintaining payer, contract, insurance plan, and billing-system setup information. The successful candidate is detail-oriented, analytical, ambitious, results-driven, comfortable multitasking in a fast-paced team, and focused on accurate setup and resolving payer and system issues. The position supports analysis through data aggregation, revenue issue resolution, and process improvement. Hybrid and remote work arrangements are available, and necessary equipment is provided.
Requirements
- High school diploma or equivalent.
- At least 2 years of healthcare experience in Revenue Operations or experience working with a variety of healthcare insurance payers.
- Experience using Microsoft Word, Excel, Access, and Outlook.
- Excellent written and verbal communication skills.
- Strong decision-making and problem-solving skills, including the ability to evaluate differing patient account and payer situations and identify appropriate actions.
- Ability to adapt quickly and manage stress in a changing environment.
- Ability to build relationships and work collaboratively with teams and other departments.
Responsibilities
- Research and enter system architecture changes for insurance setup objects that support revenue generation and claims billing.
- Implement and resolve complex payer contract requirements in DaVita systems.
- Respond to internal teams’ questions about contracts, revenue, plan management, and billing attributes.
- Perform Revenue Operations duties in contract management, revenue management, or insurance plan management, including billing templates such as UB04 and HCFA 1500.
- Communicate with insurance payers about network coverage, relationships, and contract terms to support timely and accurate reimbursement for dialysis services.
- Process payer, partner, and customer requests to ensure center and payer information, including single patient agreements, is loaded into the billing system accurately.
- Respond to payer communications and bulletins in a timely and accurate manner.
- Collaborate with other Revenue Operations teams to support seamless processes.
- Identify process changes and opportunities for continuous improvement.
- Maintain current system setup attributes, including new technology and charge master items.
- Maintain the confidentiality of company and patient information in accordance with HIPAA regulations and DaVita policies.
- Collect, analyze, interpret, and summarize data from source systems to understand how setup objects, contract and payer requirements, and system logic interact in the billing system.
- Attend team meetings, phone conferences, and training as scheduled.
- Follow teammate guidelines, employment policies, and department and company procedures.
- Work overtime as needed.
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
