Revenue Specialist II, ROPS

Revenue Specialist, Bulk Payor Analytics (BPA)The Revenue Specialist, Bulk Payor Analytics (BPA) plays a critical role in protecting enterprise revenue by identifying, influencing, and resolving systemic payor-driven credit issues at scale. Unlike traditional claims-based roles, this position operates upstream, analyzing payor behavior, negotiating resolution strategies, and partnering across Revenue Operations (ROPS), Payor Partnerships, Legal, and Compliance to eliminate credit inflow at the source.Candidates within commuting distance of business office may require onsite 1-2 times a month.The Revenue Specialist – BPA is a specialized role within Team Sonar. Unlike traditional ROPS roles that focus on working claims one-by-one, the Bulk Payor Analytics (BPA) team is dedicated to early and ongoing identification of overpayment trends, performing root cause analysis, comprising and escalating issues to the payor or internal ROPS support teams and resolving payment misalignments in bulk.In this role, you will analyze high-volume payor trends, identify upstream issues causing credit inflow (such as rate discrepancies, contract misalignments, or rounding errors), and partner with cross-functional teams (Manestream Collections, Team Spotlight, Team Lighthouse, Registration, Government Payor Alliance (GPA), Payor Partnerships, and others) to "turn off the faucet" of incoming credits. You will move beyond transactional work to strategic problem-solving, helping to protect revenue and improve operational efficiency for the Village.Essential Duties & ResponsibilitiesRoot Cause Analysis & Trend Identification:Deep-dive into high-volume payor data to identify credit balance trends and differentiate credits from overpaymentsAnalyze payor reimbursement behavior against contracts to identify discrepancies (e.g., rate errors, non-covered services, rounding issues)Investigate the "why" behind credit inflow to determine if issues are systemic or isolatedPayor & Stakeholder Negotiation:Serve as primary ROPS representative in discussions with payor partners to negotiate resolution paths for systemic overpayment and reimbursement issuesPresent data-backed findings to payors, analysts, and internal stakeholders to drive agreement on corrective action timelinesInfluence outcomes through clear articulation of root cause, financial impact, and operational feasibility, often without direct authorityCollaboration & Process Improvement:Partner closely with internal teams including Payor Partnerships, Spotlight, Manestream Collections, Legal, Compliance, Registration, and Admissions to address upstream drivers of credit inflowEscalate systemic contract, configuration, or process issues with clear documentation, financial impact analysis, and recommended solutionsTranslate analytical findings into actionable change, ensuring fixes are implemented, not just identifiedPresent issues on calls/meetings with key stakeholdersDevelop and manage key relationships with external partners. Develop timelines and execute the action items necessary to resolve escalationsEffective and professional communication (written and verbal) with key stakeholdersBulk Resolution & Project Work/ManagementFormulate and execute "bulk" resolution strategies to resolve large populations of claims at once (e.g., Bulk Processing Unit (BPU) files, bulk retractions, and bulk disputes) rather than processing claims individuallyManage multiple projects for targeted payors/financial classes (e.g., Medicare Advantage, Managed Medicaid, etc) to clear historical credit backlogs and prevent future inflowReview and audit BPU files with high attention to detail to ensure accuracy before processingReporting & Technical OperationsUtilize Tableau, Excel, and internal billing systems (Nautilus) to monitor inventory and track resolution progressMaintain accurate documentation of identified trends and resolution plansManage payor portfolio and inventory effectively meeting commitments for both BPA specific requirements as well as for upstream/external partiesQualificationsHigh school diploma or equivalentStrong critical thinking and problem-solving skills: Ability to look at a situation, identify patterns, and determine the best course of action. Creative thinker who embraces trying new approaches and learn from other perspectivesIntermediate Excel skills: Ability to work with data sets, filter, sort, and perform basic analysisAttention to detail: Crucial for auditing bulk files where a single error can affect hundreds of claims. Strong written and verbal communication skills for interacting with payors and internal teamsAdaptable and agile – Able to operate in a fast-paced environment where day to day priorities can shift. Comfortable with navigating change and able to approach large change management events with positive focusAbility to synthesize complex data into clear narratives for senior leaders and external partnersNavigate ambiguity and drive alignment across multiple stakeholders with competing prioritiesDemonstrate experience influencing outcomes without direct authorityTime Management: Understands how to effectively manage their time and prioritize the correct work, meet deadlines, and self-correct when neededAccountability: Holds themselves to high-quality standard of work and exudes a continuous-improvement mindset at all times. Self-starter with workloadKnowledge of insurance rules and regulations (Medicare Advantage, Medicaid, Commercial, etc)Experience with DaVita revenue cycle systems (Nautilus, CAT, Reggie, etc.)Experience reading and interpreting payor contracts and explanation of benefits (EOBs)What You Can ExpectA "Community First, Company Second" Culture: We are a team that supports one another. You will join a village where we care for our patients and each otherAutonomy & Impact: You will own a specific "book of business" or project scope, giving you the opportunity to drive real results that impact the bottom lineGrowth Opportunities: This role offers deep exposure to the analytical side of Revenue Operations, paving the way for future growth into analyst or leadership rolesWhat We'll Provide:More than just pay, our DaVita Rewards package connects teammates to what matters most. Teammates are eligible to begin receiving benefits on the first day of the month following or coinciding with one month of continuous employment. Below are some of our benefit offeringsComprehensive benefits: Medical, dental, vision, 401(k) match, paid time off, PTO cash outSupport for you and your family: Family resources, EAP counseling sessions, access Headspace®, backup child and elder care, maternity/paternity leave and moreProfessional 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.