Revenue Specialist I

This is a fully remote position, open to applicants in Oregon.

📋 Description

• Collaborate closely with practice leaders to explore and design strategic initiatives aimed at enhancing revenue cycle metrics, reporting capabilities, and overall performance.

• Design, implement, and support business and administrative analytics within the revenue cycle functional areas.

• Create reports featuring key performance indicators (KPIs), metrics, data points, and formulas to assist in achieving management objectives.

• Evaluate processes to ensure alignment with best practices, leading to optimal results, measurable improvements, and quantifiable positive contributions.

• Aid in the preparation of net revenue estimates.

• Analyze trends in fee-for-service collections.

• Identify and execute process, technology, and training initiatives that promote accurate and timely billing and accounts receivable collections.

• Provide analytical support and develop tools to assist operations in recognizing current and potential performance issues.

• Investigate healthcare revenue cycle best practices and standards to facilitate standardized goal setting and performance monitoring.

• Develop, manipulate, and analyze large datasets for process improvement strategies.

• Audit electronic reports and paper claims, making corrections as needed.

• Ensure that performance information is accessible and flows smoothly to relevant parties, addressing data transmission issues as they arise.

• Analyze financial and revenue cycle performance data to uncover trends, patterns, and root causes.

⛳️ Requirements

• A minimum of 1 year of relevant healthcare claims experience, specifically in identifying insurance underpayments and revenue recovery.

• Over 1 year of experience in healthcare finance, reimbursement, public or other accounting, auditing, budgeting, compliance, billing, or insurance, with increasing responsibility in analysis and project management.

• 1–3 years of experience in data or financial analysis.

• Highly analytical with substantial reconciliation experience and a strong working knowledge of accounting principles.

• Familiarity with Average Wholesale Price (AWP) pricing rules.

• Knowledge of pharmacy and major medical healthcare billing practices.

• Understanding of commercial and government healthcare reimbursement methodologies.

• Strong knowledge of hospital billing and managed care systems.

• Comprehension of the 837/EDI process, including payer-specific regulations.

• Proficient technical skills and advanced expertise in Excel.

• Experience with billing, coding, and collaborating with clinicians.

• Prior experience in project management.

• Ability to work independently and efficiently.

• Excellent verbal and written communication skills.

• Strong systems skills and organizational abilities.

• Self-motivated with a proactive approach.

• Proficient in telephone and email communications.

🏝️ Benefits

• Medical insurance

• Dental insurance

• Vision insurance

• 401(k) matching

• Paid time off

• PTO cash out

• Family resources

• EAP counseling sessions

• Access to Headspace®

• Backup childcare and elder care services

• Maternity/paternity leave

• Professional development programs

• On-demand virtual leadership and development courses available through DaVita’s online training platform, StarLearning