Revenue Specialist III- Credits

Role Description

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.

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, 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).
• Partner with cross-functional teams to “turn off the faucet” of incoming credits.
• Move beyond transactional work to strategic problem-solving, helping to protect revenue and improve operational efficiency for the Village.

Qualifications

• High school diploma or equivalent.
• Strong critical thinking and problem-solving skills.
• Intermediate Excel skills.
• Attention to detail.
• Adaptable and agile.
• Ability to synthesize complex data into clear narratives.
• Navigate ambiguity and drive alignment across multiple stakeholders.
• Demonstrate experience influencing outcomes without direct authority.
• Time Management skills.
• Accountability with a continuous-improvement mindset.
• Knowledge 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).

Requirements

• Deep-dive into high-volume payor data to identify credit balance trends.
• Analyze payor reimbursement behavior against contracts to identify discrepancies.
• Investigate the “why” behind credit inflow.
• Serve as primary ROPS representative in discussions with payor partners.
• Present data-backed findings to payors, analysts, and internal stakeholders.
• Influence outcomes through clear articulation of root cause, financial impact, and operational feasibility.
• Partner closely with internal teams to address upstream drivers of credit inflow.
• Escalate systemic contract, configuration, or process issues.
• Translate analytical findings into actionable change.
• Formulate and execute “bulk” resolution strategies.
• Manage multiple projects for targeted payors/financial classes.
• Utilize Tableau, Excel, and internal billing systems to monitor inventory and track resolution progress.
• Maintain accurate documentation of identified trends and resolution plans.

Benefits

• 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 to 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.