Revenue Lead, ROPS

5200 Virginia Way, Brentwood, Tennessee, 37027-7569, United States of America

About the role

This position researches and resolves high-complexity collection account balances according to DaVita policies and procedures, ensuring compliance with federal and state billing regulations. The role also provides ongoing training and guidance for Revenue Specialist teammates, performs data trending analysis, quality assurance reviews, and monitors key metrics.

Responsibilities

• Review weekly and monthly key metrics to identify trends or areas of focus; collaborate with management to develop, document, and implement action plans to address issues.
• Identify payer trends and root causes of billing or claim exceptions; take appropriate steps to resolve and/or escalate issues to minimize bad debt.
• Interpret policies related to exceptions and determine appropriate business actions in the absence of policies or in cases of ambiguity.
• Escalate issues as needed and provide recommendations.
• Act as a resource for teammates’ questions and assist with 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 all close reconciliation approvals and related activities to ensure timely submission of primary, secondary, and tertiary insurance claims.
• Serve as a subject matter expert for close processes.
• Review and approve adjustments and claim appeals submitted by Specialists of Patient Accounts.
• Conduct quality assurance reviews of work output and provide feedback to teammates and management; offer suggestions for improvement.
• Manage and lead multiple projects, meet deadlines, and adjust priorities in a fast-paced work environment.
• Support department initiatives.
• Stay abreast of changes to ESRD and Medicare Secondary Provider laws.
• Maintain confidentiality of all patient, teammate, and company information in accordance with HIPAA regulations and DaVita policies.
• Adhere to DaVita teammate handbook, employment policies, safety, and security procedures.
• Consistent, regular, and punctual attendance; overtime may be required to ensure timely completion of tasks.
• Attend team meetings, phone conferences, and training as needed.
• Embrace DaVita’s culture by actively participating in village and neighborhood initiatives.
• Demonstrate DaVita’s core values in all aspects of the role.
• Less than 5% travel required.

Requirements

• High School diploma or equivalent required.
• Two to four years’ experience in healthcare reimbursement and revenue cycle management preferred.
• Intermediate proficiency in MS Excel, Word, and PowerPoint.
• Strong analytical skills, follow-through, and ability to seek underlying assumptions through probing, questioning, listening, and problem-solving.
• Ability to interact positively with all levels of the company.
• Commitment to DaVita’s values: Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment, and Fun.

Benefits

• Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out.
• Support for you and your family: Family resources, EAP counseling sessions, access to Headspace®, backup child and elder care, maternity/paternity leave.
• Professional development programs: Career growth opportunities, on-demand virtual leadership and development courses through DaVita’s online training platform, StarLearning.
• Community-focused culture: Strive to be "a place where I belong" by embedding belonging into village initiatives.

Pay

The wage range for this role is $22.50 - $31.00/hour. Compensation depends on qualifications, skills, competencies, and experience. Location-specific minimum wage details are available at DaVita.jobs/WageRates.

New York (Exempt): New York City and Long Island: $66,300/year; Nassau, Suffolk, and Westchester counties: $66,300/year; remainder of New York state: $62,353.20/year.

New York (Non-exempt): New York City and Long Island: $17.00/hour; Nassau, Suffolk, and Westchester counties: $17.00/hour; remainder of New York state: $16.00/hour.

Washington (Exempt): $80,168.40/year.

Washington (Non-exempt): Bellingham: $19.13/hour; Burien: $21.71/hour; Everett: $20.77/hour; Unincorporated King County: $20.82/hour; Renton: $21.57/hour; Seattle: $21.30/hour; Tukwila: $21.65/hour; remainder of Washington state: $17.13/hour.