Revenue Specialist I (ROPS)

SCHEDULE: Monday - Friday, Daytime Hours! 

Full-time, Permanent Opportunity | Flexible Scheduling | Community-based Work Culture | Comprehensive Benefits Package 

What Will You Do? 

This position performs revenue cycle duties including but not limited to: 

processing Out of Network patient authorizations ensuring the timely and accurate submission of requests to ensure patients are cleared to treat. 

Example of daily responsibilities includes: 

• Perform duties for revenue operations department related to authorizations. 

• Communicate with insurance payers to ensure proper treatment and medication authorizations for our patients to ensure timely and accurate reimbursement for dialysis services rendered at our clinics 

• Respond timely and accurately to payer communications 

• Collaborate with other revenue operations teams to ensure seamless processes across teams 

• Partner with clinics teammates such as Insurance counselors, social workers and facility administrators to ensure timely and accurate insurance information 

• Help identify process changes and opportunities for continuous improvements 

• Maintain current patient account information at all times 

• Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies 

Other duties could include: 

• May be asked to work overtime as needed 

• Attend team meetings, phone conferences, and training as needed 

• Know, understand and follow teammate guidelines, employment policies, and department or company procedures 

Experience and required skills 

• Prior Authorization experience required 

• Excellent communication skills: (Written & Verbal). The position involves regular communication with insurance payors, employers, or other teams. 

• Excellent decision making and problem-solving skills: Patient account and every insurance payor 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 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 

Minimum Qualifications 

• High school diploma or equivalent 

• Minimum of One (1) year of Registration/Authorization experience 

• Basic computer skills and proficiency in MS Word, Excel, and Outlook 

Training provided by DaVita:  

• Knowledge of revenue cycle, insurance rules, and regulations for federal, state, and/or managed care payers in multiple states 

• Knowledge of Out of Network authorization practices  

• Usage of DaVita systems  

• Basic medical terminology 

• Basic knowledge of healthcare authorization principles