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ROPS Specialist II (lab) - Remote Eligible

Secure maximum reimbursement by managing insurance claim denials and appeals efficiently.
Remote
Junior
1 week ago
DaVita

DaVita

A healthcare provider specializing in kidney care and dialysis services for patients with chronic kidney failure and end-stage renal disease.

Rops Specialist Ii, Collections (Lab)

The ROPS Specialist II, Collections (Lab) is to secure maximum reimbursement on all claims based on payer terms. Applies the knowledge and skills to complete a wide range of tasks at a level which meets department standards and ensures goals and objectives are achieved. Ensures claim adjustments are applied using the appropriate payer terms and based on department guidelines. Adheres to DaVita policies including corporate compliance and all rules and regulations under the applicable local, state, and federal agencies and accrediting bodies. This position reports to the Supervisor, Patient Accounting (Lab).

Essential Duties & Responsibilities

  • Initiates collection follow up of all denials with insurance payer to ensure proper reimbursement on claims. Researches, appeals, resolves claim rejections and underpayments with the payer based on payer terms.
  • Responds to written payer communications with appropriate action in timely manner; Processes claims, re-bills and appeals; Requests medical documentation from facilities; Types, scans (files in electronic claims library by payer) and mails appeal.
  • Documents daily in the A/R system all follow up and communication on a patient account in a consistent and concise format and escalates issues to lead and supervisor based on department standards
  • Validates and requests insurance changes through the A/R system as required during collections process.
  • Retrieves assigned data and prioritizes based on AR department guidelines

Education And Experience

  • 2-4 years experience preferred
  • Intermediate computer skills and proficiency in MS Word, Excel, Outlook, and an electronic accounts receivable system required
  • Must have high school diploma

About DaVita Laboratories

DaVita Labs is a state-of-the-art clinical laboratory delivering timely, accurate lab results focused primarily on kidney care with a relentless commitment to quality. We serve more than 180,000 patients and perform 52 million renal tests annually. We make a difference. We enjoy what we do. Our teammates are best in class professionals who enjoy a challenging yet rewarding work environment where fun and hard work intermingle every day. From our laboratory professionals to our support roles, DaVita labs not only offers a career to fit each individual, it provides a community and a place to call home. As a labs teammate, you become a member of our community and you also become a citizen of something bigger, something great, and something unique - the DaVita Village. With the backing of the overall DaVita brand, we are on an exciting trajectory. Check out our short video to hear directly from teammates as to why YOU should join OUR Village! Here is what you can expect when you join our Village:

  • A "community first, company second" culture based on Core Values that really matter.
  • Clinical outcomes consistently ranked above the national average.
  • Award-winning education and training across multiple career paths to help you reach your potential.
  • Performance-based rewards based on stellar individual and team contributions.
  • A comprehensive benefits package designed to enhance your health, your financial well-being and your future.
  • Dedication, above all, to caring for patients suffering from chronic kidney failure across the nation.

Why wait? Explore a career with DaVita today.

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ROPS Specialist II (lab) - Remote Eligible
Remote
Operations
About DaVita
A healthcare provider specializing in kidney care and dialysis services for patients with chronic kidney failure and end-stage renal disease.