Revenue Specialist III, ROPS

Posting Date
10/21/2025

5200 Virginia Way, Brentwood, Tennessee, 37027, United States of America

The Health Information Management (HIM) Specialist III supports DaVita's HIM operations by managing the release of Protected Health Information (PHI) in response to government audits, payor inquiries, patient requests,

and third-party Release of Information (ROI) requests.

This position ensures that all disclosures of PHI are compliant with Federal and State regulations, HIPAA laws, and organizational policies.

The HIM Specialist III plays a vital role in safeguarding patient privacy and maintaining confidentiality in all aspects of the role.

The ideal candidate demonstrates strong attention to detail, exceptional organizational skills, and a commitment to service excellence in a fast-paced, high-volume environment.

This position also provides subject matter expertise in PHI release processes and may mentor junior teammates, lead projects, and assist with training.

Responsibilities:

• Assist in developing tools and dashboards to support Health Information Management (HIM) process optimization
• Collaborate with cross-functional teams to implement improvements in process, technology, and training
• Provide analytical support and develop tools that enhance HIM operations' ability to identify current and future performance issues
• Conduct research on industry best practices and standards in health information to support performance goal setting and process standardization
• Audit both electronic and paper medical records for completeness, accuracy, and proper documentation; correct errors as necessary
• Ensure integrity and consistency in data flow and transmission across internal systems and stakeholders
• Prepare comprehensive and compliant medical record packets in response to audit requests, including RAC, CERT, ADR, OIG, and others
• Analyze medical documentation for coding accuracy and compliance (ICD-10, CPT, HCPCS)
• Compile, draft, and submit appeals and redeterminations to Fiscal Intermediaries
• Collaborate with clinics and other teams to obtain hard copy and/or electronic records as needed
• Serve as a Subject Matter Expert (SME) for audit processes, documentation regulations, and compliance requirements
• Train and mentor teammates on documentation standards, government payor audits, and ROI protocols
• Conduct quality assurance (QA) reviews on submitted medical record packets to ensure audit readiness
• Actively participate in policy review and revision through eP&P committees
• Support the maintenance of the electronic health record (EHR) and contribute to future system upgrades and implementations
• Lead and contribute to special projects related to medical documentation, audits, and operational improvements
• Review and fulfill Release of Information (ROI) requests from government agencies, commercial payors, patients, and third parties
• Ensure all PHI disclosures are handled in full compliance with HIPAA, federal/state regulations, and DaVita internal policies
• Manage escalated or complex ROI requests with professionalism, discretion, and accuracy
• Maintain complete and detailed documentation of records processed and disclosures made
• Respond to audit requests within mandated timeframes to support compliance and reimbursement efforts
• Liaise with legal, compliance, and clinical teams for complex or sensitive cases
• Consistently uphold and model patient confidentiality and data privacy standards
• Contribute to the development and maintenance of job aids, standard operating procedures (SOPs), and training materials
• Participate in and support ongoing process improvement and documentation initiatives across the HIM team

• 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.