Revenue Lead, ROPS

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

SUPERVISORY RESPONSIBILITIES: No

ESSENTIAL DUTIES AND RESPONSIBILITIES

The following duties and responsibilities generally reflect the expectations of this position but are not intended to be all-inclusive.

• Review, weekly and monthly key metrics to identify trends or areas of focus; work with Management to develop, document, and implement action plans to address issues
• Identify payer trends and or root cause of billing or claim exceptions; take appropriate steps to resolve and/or escalate issues to minimize bad debt
  • Identify and interpret policies related to exceptions
  • Determine and apply appropriate business action in absence of policies or in cases of ambiguity
  • Escalate issues as needed; provide recommendations
• Act as resource for teammate’s questions and assist with issues of focus and  problematic payer issues
• Train new teammates
• Identify training opportunities to improve individual and team performance; perform one-on-one and group training as needed
• Recommend changes on 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
• Review and approve adjustments and claims appeals submitted by Specialist of Patient Accounts
• Conduct quality assurance reviews of work output and provide feedback to teammates and management; offer suggestions for improvement
• Ability to manage and lead multiple projects, meet deadlines, and adjust priorities appropriately in a high paced work environment. Support department initiatives.
• Stay abreast of changes to ESRD and Medicare Secondary Provider laws and changes
• Strong analytical skills, follow through; with the ability to seek underlying assumptions through probing, questioning, listening, and problem solving
• Ability to interact positively with all levels of the company
• Maintain confidentiality of all patient, teammate, and company information in accordance with HIPPA regulations and DaVita policies
• Know, understand, and follow DaVita teammate handbook, employment policies, safety and security policy and procedures

•   Other duties and responsibilities as assigned including but not limited to:

• Consistent, regular and punctual attendance as scheduled
• Overtime may be required to ensure timely completion of tasks and required duties
• Attend team meetings, phone conferences, and training as needed
• Know, understand, and follow department or company procedures
• Embrace the DaVita culture by actively participating in village and neighborhood initiatives
• Demonstrate DaVita’s core values in all aspects of your role
• Less than 5% travel required

 MINIMUM QUALIFICATIONS

Education, licenses, certifications, and experience required to fulfill the essential duties, include computer skills as required.

• 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