Revenue Specialist III, ROPS

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Requirements:

• High School Diploma or equivalent required
• 2 years of healthcare experience in Revenue Operations or experience working with a variety of health care insurance payers is preferred
• Experience with using Microsoft Word, Excel, Access and Outlook
• Excellent communication skills: (Written & Verbal). The position involves regular communication with insurance payers, internal teams, and customers
• Excellent decision making and problem-solving skills: Patient account and every insurance payer is different. The ability to think through a situation and carefully identify the best action to take is critical to be successful at this role
• Ability to adapt quickly and manage stress: Our environment can change quickly and on a daily basis. Adapting and managing stress is important for success
• Relationships Building: Working in teams and with other departments is central to this position

Responsibilities:

• Research and input system architecture changes for insurance setup objects in support of generating revenue and claims for billing
• Implement and resolve highly complex payer contract requirements into DaVita’s systems
• Respond to internal teams’ inquiries on contract, revenue, plan management and billing attributes
• Perform duties for the revenue operations department related to either contract management, revenue management or insurance plan management including billing templates (i.e. UB04, HCFA 1500)
• Communicate with insurance payers to understand network coverage, relationships and contract terms to ensure timely and accurate reimbursement for dialysis services rendered at our clinics
• Process payer, partner and customer requests to ensure center and payer information is loaded into the billing system for accurate billing including single patient agreements
• Respond timely and accurately to payer communications and bulletins
• Collaborate with other revenue operations teams to ensure seamless processes across teams
• Help identify process changes and opportunities for continuous improvements
• Always maintain current system setup attributes, including new technology, and charge master items
• Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies
• Understand how setup objects/contract/payer requirements and system logic tie together in the billing system by collecting, analyzing, interpreting and summarizing data from source systems
• Attend team meetings, phone conferences, and training as scheduled
• May be asked to work overtime as needed
• Know, understand and follow teammate guidelines, employment policies, and department or company procedures