Nashville, Tennessee
Nashville, Tennessee
Baltimore, Maryland
Hacienda Heights, California
Morrisville, North Carolina
Hackettstown, New Jersey
Summit, New Jersey
Posted: 18-Mar-25
Location: Raleigh, North Carolina
Categories:
Internal Number: 255080
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
Accurately complete patient accounts based on departmental protocol,policies and procedures, and compliance with regu latory agencies, toinclude but not limited to pre-admission, admission, pre-registrationand registration functions. Ensure all insurance require ments are metprior to patients' arrival and inform patients of their fin ancialliability prior to arrival for services. Arrange payment options w iththe patients and screens patients for government funding sources.
Work Performed
Analyze insurance coverage and benefits forservice to ensure timelyreimbursement. Obtain all Prior Authorization Certification and/orauthorizations as appropriate. Facilitate payment s ources for uninsuredpatients. Determine if patient's condition is the re sult of an accidentand perform complete research to determine the approp riate source ofliability/payment. Admit, register and pre-register patie nts withaccurate patient demographic and financial data. Resolve insuran ceclaim rejections/denials and remedy expediently.Calculate andcollect c ash payments appropriately for all patients. Reconcile dailycash deposit .Evaluate diagnoses to ensure compliance with the LocalMedicare Review P olicy. Perform those duties necessary to ensure allaccounts are processe daccurately and efficiently. Compile departmentalstatistics for budgetar y and reporting purposes.Explain billsaccording to PRMO credit and colle ction policies. Implement appropriatecollection actions and assist financially responsible persons inarranging payment. Make referral for financ ial counseling. Determinenecessity of third party sponsorship and proces s patients in accordancewith policy and procedure. Examine insurance pol icies and other thirdparty sponsorship materials for sources of payment. Inform attendingphysician of patient financial hardship. Complete the ma naged carewaiver form for patients considered out of network and receivi ngservices at a reduced benefit level. Update the billing system torefle ct the insurance status of the patient. Refer patients to theManufacture r Drug program as needed for medications. Greet andprovides assistanceto visitors and patients. Explain policies andprocedures, and resolves pro blems. Gathers necessary documentation tosupport proper handling of inqu iries and complaints. Assist withdepartmental coverage as requested.Obta in authorizations basedon insurance plan contracts and guidelines. Docum ent billing systemaccording to policy and procedure. Enter and updateref errals asrequired. Communicate with insurance carriers regarding clinica linformation requested and to resolve issues relating to coverage andpay ment.
Knowledge, Skills and Abilities
Excellent comm unication skills, oral and written. Ability to analyzedata, perform mult iple tasks and work independently. Must be able todevelop and maintain p rofessional, service-oriented workingrelationships with patients, physic ians, co-workers and supervisors.Must be able to understand and complyw ith policies and procedures.
Level Characteristics
Po sition responsible for high production generated accurately inaccordance with established business processes or regulation. Requiresworking know ledge of compliance principles. Job allows the opportunityto work indepe ndently.
Minimum Qualifications
Duke is an Affirmative Action/Equal Opportunity Employer committed toproviding employment opportunity without regard to an indiv idual's age,color, disability, gender, gender expression, gender identit y, geneticinformation, national origin, race, religion, sex, sexual orie ntation,or veteran status.
Duke aspires to create a c ommunity built on collaboration,innovation, creativity, and belonging. O ur collective success depends onthe robust exchange of ideas-an exchange that is best when the richdiversity of our perspectives, backgrounds, a nd experiences flourishes.To achieve this exchange, it is essential that all members of thecommunity feel secure and welcome, that the contribut ions of allindividuals are respected, and that all voices are heard. All members ofour community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University andDuke University Health System may include essential job f unctions thatrequire specific physical and/or mental abilities. Addition alinformation and provision for requests for reasonable accommodation wi llbe provided by each hiring department.
E ducation
Work requires knowledge of basic grammar and mathematic al principlesnormally required through a high school education, with som epostsecondary education preferred. Additional training or workingknowle dge of related business.
Experience
Two years experie nce working in hospital service access, clinicalservice access, physicia n office or billing and collections. Or, anAssociate's degree in a healt hcare related field and one year ofexperience working with the public. O r, a Bachelor's degree and one yearof 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.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas-an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.
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.