Revenue Lead (collections/billing/claims)

at  DaVita

REVENUE OPERATIONS LEAD

SCHEDULE: Monday - Friday, Daytime Hours!
Full-time, Permanent Opportunity | Flexible Scheduling | Community-based Work Culture | Comprehensive Benefits Package
Job Description

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

ESSENTIAL BEHAVIORS, SKILLS AND ATTITUDES REQUIRED FOR SUCCESS IN THIS POSITION:

Commitment to DaVita’s values of Service Excellence, Integrity, Team, Continuous Improvement, Accountability, Fulfillment and Fun with ability to demonstrate those positively and proactively to patients, teammates, management, physicians, and/or vendors (Village Service Partners) in everyday performance and interactions

LANGUAGE SKILLS

Fluent in the written and verbal skills necessary to successfully perform the essential functions, duties, and responsibilities of the position.

• Ability to understand clinical/medical vocabulary written or spoken in English required.

VISUAL REQUIREMENTS:

Vision adequate to perform the essential duties and responsibilities of position.

GENERAL PURPOSE OF THE JOB

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 Revenue Specialist teammates, and performs data trending analysis, quality assurance reviews and review of key metrics.

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 and mitigate compliance risk.
• 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 invoices. Serve as a subject matter expert for close
• Review and approve adjustments, refunds, and charge disputes submitted by Revenue Specialists
• 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 updates from CMS specific to treatments in an in-patient or skilled nursing setting.
• 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 HIPAA 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

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 PowerPoin

Definition: Maintains effectiveness when experiencing various changes in work responsibilities or environment; learns and adjusts effectively to work within new work systems, processes, requirements, and act.

• Key Actions:
• Demonstrates an understanding of changes: Actively seeks information about new work situations; strives to understand the rationale and implications for changes in works responsibilities or environment.
• Embraces change openly & positively: Treats change and new situations as opportunities for learning and growth; identifies the benefits of change; speaks positively about the change to others.
• Quickly gains knowledge, understanding or skill: Demonstrate the ability to integrate new information and draws conclusions from it.
• Adjusts behavior: Quickly modifies behavior to deal effectively with changes in the work environment; tries new approaches appropriate for new or changed situations; does not persist with ineffective behaviors.
• Believes continuous improvement is a way of life: Processes the change unselfishly & seeks to understand the overall village impact

Fluent in the written and verbal skills necessary to successfully perform the essential functions, duties, and responsibilities of the position.

• Ability to understand clinical/medical vocabulary written or spoken in English required