2476 Swedesford RdSTE 150, Malvern, Pennsylvania, 19355-1456, United States of America
This position assists the ROPS Revenue Manager in the supervision of patient admissions, billing, and collections activities for the accounts receivable of assigned dialysis centers within a geographic region in accordance with company policies and in compliance with federal and state billing regulations.
Position has full supervisory responsibility for recruitment, hiring, retention, performance development, performance management, teammate relations, salary adjustments, and termination of direct reports.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Monitor daily operations and serve as department expert in accounts receivable, department policies and procedures, and federal and state guidelines
- Respond to issues, concerns, and questions
- Conduct formal and ad hoc training
- Ensure existing patient eligibility with ongoing maintenance of registrations, insurance verifications, authorizations, and referrals
- Ensure new patient insurance records are established and maintained
- Ensure procurement of initial payor authorizations and reauthorizations for treatments and services
- Ensure submission of primary, secondary, and tertiary insurance claims
- Ensure compliance with DaVita policies, procedures and guidelines, HIPAA, SOX, Medicare, and federal and state guidelines
- Ensure accurate reflection of accounts receivable; identify and adjust uncollectible balances with appropriate approvals
- Minimize bad debt by facilitating, overseeing, and ensuring team researches, appeals, and resolves claim rejections, underpayments, and denials with appropriate payors
- Ensure collection follow-up of all unpaid, underpayments, or denied claims
- Provide guidance on collection approach as needed
- Facilitate and/or advise on payor communications with appropriate action
- Identify root cause of claim exceptions; resolve and/or escalate issues as appropriate
- Review and approve adjustments as appropriate
- Monitor Direct Data Entry Internet access into Medicare claims system for accurate resolution of outstanding claims
- Coordinate responsibilities related to insurance verification and billing needs for newly-acquired centers and DeNovos
- Maintain current familiarity with payor contracts applicable to the geographic/contractual responsibilities of team
- Collaborate closely (in conjunction with Manager) with internal Revenue Operations teams to obtain information and updates on payors
- Review daily, weekly, and monthly key metrics to identify trends or areas of focus; work with Revenue Manager to develop, document and implement action plans, as appropriate
- Analyze trends and changes to anticipate future concerns and events; work with assigned centers and payors to prevent or mitigate negative outcomes
- Escalate issues, concerns and changes in payer behavior reporting as appropriate to Manager
- Coordinate resolution of issues and concerns regarding claims processing and billing issues across the revenue cycle
- Provide multi-level reports and communication as directed
- Compile monthly Operations Reviews based on analytics and input from team
- Develop and maintain strong relationships with internal operational constituents
- Maintain current and thorough understanding of dialysis reimbursement and industry norms
- Maintain confidentiality of all company and patient information in accordance with HIPAA regulations and DaVita policies
- Travel required: up to 25%
- Provide leadership to direct reports
- Help direct reports overcome any organizational obstacles encountered during projects
- Manage all teammate employment activity such as hiring, promoting, job performance, evaluations, and disciplinary actions with appropriate approvals as required
- Address teammate relations issues appropriately and escalate to Manager as necessary
- Know, understand, implement, follow, and communicate to teammates all DaVita employment policies and procedures, awards, and other opportunities within company and foster a positive work environment
- Ensure all DaVita employment processes are completed timely and in compliance with DaVita policy and any applicable laws including but not limited to ePCNs, Performance Development Reviews, teammate personnel file maintained, etc.
- Facilitate teammate development (PDRs, coaching, mentoring, DaVita training, outside training); collaborate with direct reports to create professional development goals
- Maintain familiarity with and communicate to teammates DaVita programs impacting teammates (including but not limited to: Triple Crown, We Are Here, Tuition Reimbursement, Foundations, etc.)
- Provide work direction for department teammates
- Determine staffing plans that promote the most effective use of all teammates; ensure coverage during teammate absences
- Know and understand basic wage and hour laws, federal, state and local laws and regulations, Medicare, and legislation affecting employment
- Review and approve time cards of hourly direct reports for bi-weekly payroll
- Track overtime, attendance, and PTO
- Develop and conduct educational programs to keep teammates up-to-date on DaVita policies, new laws and regulations impacting work, and other information necessary to maintain teammates' knowledge of department processes and goals
- Know, understand, follow, and implement DaVita safety and security policies and procedures
- Bachelor's degree in related area required; degree in Business or Finance preferred
- Minimum of two (2) years' revenue cycle, finance, or process innovation experience required
- Minimum of one (1) year's experience in medical billing and/or collections preferred
- Minimum of three (3) years' supervisory experience preferred
- Intermediate computer skills and proficiency in MS Word, Excel, and Outlook required; basic proficiency in PowerPoint preferred; prior experience using electronic billing system strongly preferred; proficiency in DaVita electronic billing system required within 90 days of employment or promotions
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.
Join us as we pursue our vision "To Build the Greatest Healthcare Community the World has Ever Seen."
Why wait? Explore a career with DaVita today.
Go to http://careers.davita.com to learn more or apply.
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 Diversity & 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 an affirmative action employer. As such, 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.
Salary/ Wage Range
Compensation for the role will depend on a number of factors, including a candidate's qualifications, skills, competencies and experience and may fall outside of the range shown. DaVita offers a competitive total rewards package, which includes a 401k match, healthcare coverage and a broad range of other benefits. Learn more at https://careers.davita.com/benefits
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