Revenue Specialist III, ROPS

Posting Date

04/27/2026

2000 16th St, Denver, Colorado, 80202-5117, United States of America

Position Summary

The Revenue Specialist, Bulk Payor Analytics (BPA) plays a critical role in protecting enterprise revenue by identifying, influencing, and resolving systemic payor-driven credit issues at scale. Unlike traditional claims-based roles, this position operates upstream, analyzing payor behavior, negotiating resolution strategies, and partnering across Revenue Operations (ROPS), Payor Partnerships, Legal, and Compliance to eliminate credit inflow at the source. 

Candidates within commuting distance of business office may require onsite 1-2 times a month.

The Revenue Specialist – BPA is a specialized role within Team Sonar. Unlike traditional ROPS roles that focus on working claims one-by-one, the Bulk Payor Analytics (BPA) team is dedicated to early and ongoing identification of overpayment trends, performing root cause analysis, comprising and escalating issues to the payor or internal ROPS support teams and resolving payment misalignments in bulk.

In this role, you will analyze high-volume payor trends, identify upstream issues causing credit inflow (such as rate discrepancies, contract misalignments, or rounding errors), and partner with cross-functional teams (Manestream Collections, Team Spotlight, Team Lighthouse, Registration, Government Payor Alliance (GPA), Payor Partnerships, and others) to “turn off the faucet” of incoming credits. You will move beyond transactional work to strategic problem-solving, helping to protect revenue and improve operational efficiency for the Village.

Essential Duties & Responsibilities

Root Cause Analysis & Trend Identification:

• Deep-dive into high-volume payor data to identify credit balance trends and differentiate credits from overpayments

• Analyze payor reimbursement behavior against contracts to identify discrepancies (e.g., rate errors, non-covered services, rounding issues)

• Investigate the “why” behind credit inflow to determine if issues are systemic or isolated

Payor & Stakeholder Negotiation:

• Serve as primary ROPS representative in discussions with payor partners to negotiate resolution paths for systemic overpayment and reimbursement issues

• Present data-backed findings to payors, analysts, and internal stakeholders to drive agreement on corrective action timelines

• Influence outcomes through clear articulation of root cause, financial impact, and operational feasibility, often without direct authority

Collaboration & Process Improvement: 

• Partner closely with internal teams including Payor Partnerships, Spotlight, Manestream Collections, Legal, Compliance, Registration, and Admissions to address upstream drivers of credit inflow

• Escalate systemic contract, configuration, or process issues with clear documentation, financial impact analysis, and recommended solutions

• Translate analytical findings into actionable change, ensuring fixes are implemented, not just identified

• Present issues on calls/meetings with key stakeholders

• Develop and manage key relationships with external partners. Develop timelines and execute the action items necessary to resolve escalations

• Effective and professional communication (written and verbal) with key stakeholders

Bulk Resolution & Project Work/Management

• Formulate and execute “bulk” resolution strategies to resolve large populations of claims at once (e.g., Bulk Processing Unit (BPU) files, bulk retractions, and bulk disputes) rather than processing claims individually

• Manage multiple projects for targeted payors/financial classes (e.g., Medicare Advantage, Managed Medicaid, etc) to clear historical credit backlogs and prevent future inflow

• Review and audit BPU files with high attention to detail to ensure accuracy before processing

Reporting & Technical Operations

• Utilize Tableau, Excel, and internal billing systems (Nautilus) to monitor inventory and track resolution progress

• Maintain accurate documentation of identified trends and resolution plans

• Manage payor portfolio and inventory effectively meeting commitments for both BPA specific requirements as well as for upstream/external parties

Qualifications

Required: High school diploma or equivalent

• Strong critical thinking and problem-solving skills: Ability to look at a situation, identify patterns, and determine