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