Claims Resolution: Investigate and resolve complex negative receipts, retractions, and recoup postings on patient accounts to ensure accurate claim balances.
Cross-Functional Collaboration: Partner with internal teams—including Team Reach—to coordinate payment postings, manage apply-back rules, and resolve general ledger (GL) discrepancies.
Root Cause Analysis: Perform deep dives into recurring claim issues to identify broader trends and resolve bigger picture problems, preventing future negative receipts.
Payer Escalations & Appeals: Submit formal appeals and escalation letters to payers regarding retractions, missing payments, and DaVita issued refunds. Follow up consistently to track payer responses.
Account Reconciliation & Adjustments: Audit patient accounts to correct misapplied funds, reallocate payments between primary and secondary insurances, and apply appropriate financial adjustments to ensure accurate billing records.
Performance Metrics: Maintain high performance on core team metrics.

High school diploma or GED, required
Associates or Bachelor’s degree, highly preferred
Ability to research and problem solve, using analytical and critical thinking skills
Healthcare and medical billing/collections experience
Intermediate computer proficiency in Microsoft Office including: Word, Excel, and Outlook
Demonstrated history of resolving challenging issues
Technical Proficiency: Experience utilizing issue tracking software and intermediate-to-advanced Microsoft Excel skills (e.g., Pivot Tables, reporting trackers)
Communication: Excellent written and verbal communication skills for effective payer outreach and clear internal collaboration
Culture Fit: A strong commitment to team engagement, accountability, and living the DaVita Way.

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.

Revenue Specialist III

Key skills