Revenue Specialist II

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

📋 Description

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

• Implement, design, and provide support for business and administrative analytics within revenue cycle functional areas.

• Create reports featuring KPIs, metrics, data points, and formulas to align with management objectives.

• Align processes with best practices to ensure optimal results and measurable improvements.

• Assist in the preparation of net revenue estimates.

• Analyze trends in fee-for-service collections.

• Identify and implement initiatives related to processes, technology, and training to support accurate and timely billing and accounts receivable collection.

• Provide analytical support and develop operational tools to help identify current and future performance issues.

• Research healthcare revenue cycle best practices and standards to aid in standardized goal setting and performance monitoring.

• Develop and manipulate large datasets and analyze data groups for strategies aimed at process improvement.

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

• Ensure the accessibility and flow of performance information to relevant parties while addressing data transmission issues.

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

⛳️ Requirements

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

• At least 1 year of experience in healthcare finance, reimbursement, public or other accounting, auditing, budget, compliance, billing, or insurance, with progressive responsibilities in analysis and project management.

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

• Familiarity with AWP pricing rules.

• Knowledge of pharmacy and major medical healthcare billing.

• Understanding of 837/EDI processes, including payer-specific rules.

• Familiarity with commercial and government healthcare reimbursement methodologies.

• Strong understanding of hospital billing and managed care.

• Advanced Excel proficiency.

• Strong technical, systems, reconciliation, accounting, auditing, and analytical skills.

• Working knowledge of healthcare billing and coding, with experience in working with clinicians.

• Prior experience in project management.

• Excellent verbal and written communication abilities.

• Capability to work independently.

• Proficient in defining problems, collecting data, establishing facts, and drawing valid conclusions.

• Skilled in interpreting technical instructions in mathematical or diagram form.

🏝️ Benefits

• Medical, dental, and vision coverage.

• 401(k) match.

• Paid time off.

• PTO cash out.

• Family resources.

• EAP counseling sessions.

• Access to Headspace®.

• Backup child and elder care.

• Maternity/paternity leave.

• Professional development programs.

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