ROPS Specialist II (Healthcare Insurance Collections)(Lab)

DAVITA

6d

About The Position

The ROPS Specialist II, Collections (Lab) is to secure maximum reimbursement on all claims based on payer terms. Applies the knowledge and skills to complete a wide range of tasks at a level which meets department standards and ensures goals and objectives are achieved. Ensures claim adjustments are applied using the appropriate payer terms and based on department guidelines. Adheres to DaVita policies including corporate compliance and all rules and regulations under the applicable local, state, and federal agencies and accrediting bodies. This position reports to the Supervisor, Patient Accounting (Lab).

Requirements

• 2-4 years experience preferred
• Intermediate computer skills and proficiency in MS Word, Excel, Outlook, and an electronic accounts receivable system required
• Must have high school diploma

Responsibilities

• Initiates collection follow up of all denials with insurance payer to ensure proper reimbursement on claims.
• Researches, appeals, resolves claim rejections and underpayments with the payer based on payer terms.
• Responds to written payer communications with appropriate action in timely manner; Processes claims, re-bills and appeals; Requests medical documentation from facilities; Types, scans (files in electronic claims library by payer) and mails appeal.
• Documents daily in the A/R system all follow up and communication on a patient account in a consistent and concise format and escalates issues to lead and supervisor based on department standards
• Validates and requests insurance changes through the A/R system as required during collections process.
• Retrieves assigned data and prioritizes based on AR department guidelines

Benefits

• Medical, dental, vision, 401(k) match, paid time off, PTO cash out
• Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave and more
• DaVita offers a variety of programs to help strong performers grow within their career and also offers 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
• Number of Employees: 5,001-10,000 employees