Revenue Specialist I – Rops

Revenue Specialist I – Rops

Requirements

• High school Diploma or equivalent (required)
• Intermediate computer proficiency in Microsoft Office tools including Excel, PowerPoint and Outlook (required)
• 1+ years general accounting or algebra math skills (required)

Responsibilities

• Research, initiate follow-up, and resolve all unpaid or underpaid system debit balances on Medicare insurance claims; Actions include but are not limited to remit and EOB review, calling payer(s) and clinics, rebilling claims, navigating payer portals, and taking adjustments in the billing system
• Uses critical thinking, problem-solving and analytical skills to determine the root cause of our underpayments and follow appropriate documented policy and procedure to remediate
• Navigate through various payer systems and multiple internal systems to ensure timely and accurate resolution of Medicare claims
• Uses exceptional organization, written, and verbal communication skills to produce detailed documentation of research and actions taken on claims
• Stay current on communication relating to healthcare reimbursement and regulatory changes
• Develop and maintain positive working relationships with clinical personnel, teammates, and payer representatives
• Works well under pressure in a fast-paced environment, meets expectations of deadlines, and carries out assignments to completion while maintaining a positive attitude
• Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies
• Consistent and punctual attendance as scheduled is an essential responsibility of this position

Preferred Qualifications

• Healthcare and medical billing/collections/denial remediation or refund experience (preferred)
• 1+ years of experience with generic accounting, transactions, or medical billing systems (preferred)