Revenue Specialist II

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

📋 Description

• Collaborate with practices and leadership 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 across revenue cycle functional areas.

• Create reports featuring key performance indicators, metrics, data points, and formulas that align with management objectives.

• Streamline processes in accordance with best practices to achieve optimal outcomes, measurable improvements, and quantifiable positive impacts.

• Assist in formulating estimates of net revenues.

• Examine trends in fee-for-service collections.

• Identify and execute initiatives related to processes, technology, and training that enhance accurate and timely billing and accounts receivable collection.

• Offer analytical support and develop operational tools to pinpoint current and future performance challenges.

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

• Generate and manipulate extensive datasets and analyze data groups to develop process-improvement strategies.

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

• Ensure the accessibility and flow of performance information to relevant stakeholders and resolve data transmission issues.

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

⛳️ Requirements

• Minimum of 1 year of relevant experience in healthcare claims, focusing on 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 responsibilities in analysis and project management.

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

• Familiarity with AWP pricing regulations.

• Understanding of pharmacy and major medical healthcare billing.

• Knowledge of 837/EDI processes, including payer-specific regulations.

• Familiarity with commercial and government healthcare reimbursement methodologies.

• Strong understanding of hospital billing and managed care.

• Significant expertise in reimbursement rules, regulations, accounting, and auditing principles.

• Working knowledge of healthcare systems, including billing, coding, and collaboration with clinicians.

• Prior experience in project management.

• Advanced proficiency in Excel and strong technical capabilities.

• Excellent reconciliation skills and a solid foundation in accounting knowledge.

• Strong verbal and written communication abilities.

• Capability to identify problems, gather data, establish facts, and draw valid conclusions.

• Ability to interpret technical instructions in mathematical or diagrammatic formats.

• Capacity to work independently.

• Highly organized with a proactive approach to independent work.

🏝️ Benefits

• Comprehensive medical, dental, and vision coverage.

• 401(k) matching program.

• Paid time off.

• PTO cash-out option.

• Family support resources.

• EAP counseling sessions.

• Access to Headspace®.

• Backup child and elder care services.

• Maternity and paternity leave.

• Professional development opportunities.

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