ROPS Specialist II (lab)

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.

Join us as we pursue our vision "To Build the Greatest Healthcare Community the World has Ever Seen."

What We'll Provide:

More than just pay, our DaVita Rewards package connects teammates to what matters most. Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offerings.

• Comprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash out
• Support for you and your family: Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave and more
• Professional development programs: DaVita offers a variety of programs to help strong performers grow within their career and also offers on-demand virtual leadership and development courses through DaVita's online training platform StarLearning.

At DaVita, we strive to be a community first and a company second. We want all teammates to experience DaVita as "a place where I belong." Our goal is to embed belonging into everything we do in our Village, so that it becomes part of who we are. We are proud to be an equal opportunity workplace and comply with state and federal affirmative action requirements. Individuals are recruited, hired, assigned and promoted without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, protected veteran status, or any other protected characteristic.