Specialist II, ROPS (Lab)

DaVita Kidney Care

19h

About The Position

The ROPS Specialist II, Collections (Lab) secures maximum reimbursement on claims based on payer terms. The role applies the knowledge and skills needed to complete a wide range of tasks at a level that meets department standards and achieves goals and objectives. It ensures claim adjustments are applied using appropriate payer terms and department guidelines, and follows DaVita policies, corporate compliance requirements, and applicable local, state, and federal rules and regulations, including those of accrediting bodies. The position reports to the Supervisor, Patient Accounting (Lab). DaVita Labs is a clinical laboratory focused primarily on kidney care, providing timely and accurate lab results. The role is part of a team and community committed to quality, patient care, and healthcare discovery.

Requirements

High school diploma.
Intermediate computer skills and proficiency in MS Word, Excel, Outlook, and an electronic accounts receivable system.

Nice To Haves

2–4 years of experience preferred.

Responsibilities

Initiate collection follow-up with insurance payers on denials to ensure proper claim reimbursement.
Research, appeal, and resolve claim rejections and underpayments based on payer terms.
Respond to written payer communications with appropriate action in a timely manner.
Process claims, rebills, and appeals.
Request medical documentation from facilities; type, scan and file documents in the electronic claims library by payer; and mail appeals.
Document follow-up and communications on patient accounts daily in the A/R system in a consistent, concise format.
Escalate issues to the lead and supervisor according to department standards.
Validate and request insurance changes through the A/R system as needed during collections.
Retrieve assigned data and prioritize it according to A/R department guidelines.

Benefits

Comprehensive 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.
Education and training across multiple career paths.
Professional development programs and on-demand virtual leadership and development courses.
Performance-based rewards.