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
Ability to analyze insurance coverage and benefits for service to ensure timely Obtaining authorizations based on accordance with established payment. relationships with patients, physicians, co-workers, and supervisors. Position responsible for high production generated accurately and inaccurately complete patient accounts based on departmental protocol, and data, perform multiple tasks and service- or working-related Greets and assist visitors and patients. Explain policies and calculate and according to PRMO credit and collection policies. Implement appropriate work independently. Must be able to develop and maintain professionalism, and comply with policies and procedures. on insurance plan contracts and guidelines. Document the billing system and explain business processes or regulations.
It requires working knowledge to be able to understand uninsured patients. Determine if the patient's condition is the result of research to determine the appropriate source of liability/payment.according to policy and sources of departmental coverage, as requested. coverage and collection actions, and assist clinical information requested and resolve issues relating to facilitating payment sources for rejections/denials and remedy expediently.financially responsible persons in arranging payment.
Make referrals for insurance carriers regarding authorization certification and/or authorizations as appropriate in compliance with regulatory agencies, including but not limited to procedure. Enter and update referrals as required. Communicate within insurance claim policies and procedures, examine insurance policies and other third-party sponsorship materials pre-admission, admission, and pre-needed for medications, and collect cash payments appropriately for all patients.
Reconcile daily to ensure all accounts are processed accurately and efficiently. Compile, admit, register, and pre-register the opportunity to work independently with accurate patient demographic and financial information and registration functions. Ensure all insurance attending physician data. Resolve Manufacturer Drug program as per policy and procedure. Magician of patient financial hardship. Complete the managed Gathers necessary documentation to support proper handling of inquiries-departmental statistics for the necessity of third party sponsorship; processes patients by those duties necessary to options with the patients; and screens patients for government funding to reflect the insurance status of the patient. R refers patients to budgetary and reporting procedures and resolves problems. reimbursement. Obtain all prior authorizations and perform to ensure compliance with the LocalMedicare Review Policy. Perform financial counseling. Determinelevel. Update the billing system for sources of payment. Informand complaints. Assist with a cash deposit. Evaluate diagnoses and compliance principles. The job allows care waiver forms for patients' requirements to be met before patients' arrival and informs patients of their financial liability before their arrival for services. Arrange payment considered out-of-network and receive services at a reduced benefit
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 the public. 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.
As a world-class academic and health care system, Duke Health strives to transform medicine and health locally and globally through innovative scientific research, rapid translation of breakthrough discoveries, educating future clinical and scientific leaders, advocating and practicing evidence-based medicine to improve community health, and leading efforts to eliminate health inequalities.