At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.
About Duke Health's Patient Revenue Management Organization
Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.
Occ Summary Work PerformedKnowledge, Skills and Abili tiesLevel Characteristicsandand procedures.informationfortotoExcellent c ommunication skills, oral and written. Ability to analyzeAnalyze insuran cecoverage and benefits for service to ensure timelyObtain authorization sbasedpayment.Position responsible for high production generated accurat elyinAccurately complete patient accounts based on departmental protocol ,data, perform multiple tasks andservice-oriented workingGreet andprovid esassistance to visitors and patients. Explain policies andCalculate and according to PRMO credit and collection policies. Implement appropriateo ninsurance plan contracts and guidelines. Document billing systemExplain billsaccording to policy anddepartmental coverage as requested.procedure .collection actions and assistFacilitate payment sources forfinanciallyr esponsible persons in arranging payment. Make referral formedications.Au thorization Certification and/or authorizations as appropriate.complianc ewith regulatory agencies, to include but not limited topolicies and pro cedures, andExamine insurance policies and other third party sponsorship materialspre-admission, admission, pre-collect cash payments appropriate ly for all patients. Reconcile dailywithpolicy and procedure.attendingph ysician of patient financial hardship. Complete the managedGathersnecess ary documentation to support proper handling of inquiriesnecessityof thi rd party sponsorship and process patients in accordanceprocedures, andre solves problems.reimbursement. Obtain all Priorfinancial counseling.Dete rminelevel. Update the billing systemfor sources of payment. Informand c omplaints. Assist withcash deposit. Evaluate diagnosescare waiver form f or patientsworkregistrationand registration functions. Ensure all insura nce requirementsare metprior to patients' arrival and informpatientsof t heir financial liability prior to arrival for services.Arrangepayment op tions with the patientsscreens patients for government funding sources.u ninsuredpatients. Determine if patient's condition is the result ofurce of liability/payment. Admit, registerand pre-register patients withan ac cidentand perform complete research todetermine the appropriate soaccura tepatient demographic and financial data. Resolve insuranceclaimrejectio ns/denials andremedyexpediently.ensure compliance with theLocal Medicare Review Policy. Perform thoseduties necessary to ensureallaccountsare pr ocessed accurately and efficiently. Compile departmentalstatistics for b udgetary andreporting purposes.considered out of networkand receiving se rvicesat a reduced benefitreflect the insurance status of the patient. R efer patients to theManufacturer Drug program as neededEnter andupdate r eferrals as required. Communicate with insurancecarriers regarding clini calrequested and to resolve issues relating to coverageandindependently. Must be able to develop and maintain professional,relationshipswith pat ients, physicians, co-workers and supervisors. Must beable tounderstand and comply withpoliciesprocesses or regulation. Requires workingknowledg e of complianceaccordance with established businessprinciples.Job allows theopportunityto work independently.
Minimum Qualifications
Education
Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some postsecondary education preferred. Additional training or working knowledge of related business.
Experience
Two years experience working in hospital service access, clinical service access, physician office or billing and collections. Or, an Associate's degree in a healthcare related field and one year of experience working with thepublic. Or, a Bachelor's degree and one year of experience working with the public.
Degrees, Licensures, Certifications
None required
Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
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Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.