Revenue Specialist III

Role Overview

• Perform revenue cycle duties including but not limited to: 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
• Example of daily responsibilities includes: 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
• Other duties could include: May be asked to work overtime as needed
• Know, understand and follow teammate guidelines, employment policies, and department or company procedures

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
• 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

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 Headspace ® , backup child and elder care, maternity/paternity leave and more
• Professional development programs: DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita’s online training platform StarLearning.