Northern & Central California, California
Northern and Central California, California
Central California, California
Santa Rosa, California
Northern and Central California, California
Santa Rosa, California
Northern & Central California, California
Orlando, Florida
Indianapolis, Indiana
Allentown, Pennsylvania
Posted: 20-Mar-25
Location: Durham, North Carolina
Categories:
Internal Number: 255397
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.
Duke Dermatology Clinic (South Durham)
Occ Summary
Ability to analyze and Analyze insurance coverage and benefits for vice to ensure timely. Obtaining authorizations for the established payment. Position responsible for high production generated accurately in Accurately completing patient accounts based on departmental protocol, greeting, and assisting visitors and patients. Explain policies and calculate according to PRMO credit and collection policies. Implement appropriate insurance plan contracts and guidelines.
Document billing system: explain billing relationships with patients, coverage, and medication policies and procedures, considered out-of-network and receiving services at a reduced benefit, and compliance with regulatory agencies, including but not limited to pre-admission, pre-registration, and regulatory functions. Ensure all insurance requirements are met before patients' arrival and inform patients of their financial liability before receiving services.
Arrange payment options with the patients and screen patients for government funding sources. Departmental coverage as well as payments are appropriate for all patients. Reconcile the daily necessity of third-party sponsorship and process patients with reimbursement.
Obtain Prior Authorization Certification and/or authorizations as appropriate. Facilitate payment sources for uninsured patients. Determine if the patient's condition is the result of an accident and perform a complete review to determine the appropriate source of liability/payment. Admit, register, and pre-register patients with accurate patient demographics and data. Resolve insurance claim rejections/denials and remedy expediently. Cash deposit. Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy. Perform those duties necessary to ensure all accounts are processed accurately and efficiently. Compile departmental statistics for budgetary and reporting purposes. Collect actions and assist financially responsible persons in arranging payment. Make referrals for financial counseling. Determine with policy and procedure. Examine insurance policies and any other third-party sponsorship materials for sources of payment. I informed the attending physician of the patient's financial hardship. Complete the managed caregiver form for the patient level. Update the billing system to reflect the insurance status of the patient. Refer patients to the Manufacturer Drug Program as needed for procedures and resolve problems.
Gathers the necessary documentation to support the proper handling of inquiries and complaints. Assist according to policy and procedure. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information requested and resolve issues relating to physicians, co-workers, and supervisors. Data, perform multiple tasks, and work independently. Must be able to develop and maintain professional, service-oriented work. Must be able to understand and comply with policies and procedures. Business processes or regulations. Requires working knowledge of compliance principles. The job allows the opportunity to work independently.
Minimum Qualifications
Duke is an affirmative action/equal opportunity employer committed to providing employment opportunities 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 essential job 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.
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 the related business.
Experience
Two years of experience working in hospital service access, clinical service access, a physician's office, or billing and collections. Or, an associate's degree in a healthcare-related field and one year of experience working with the public. A bachelor's degree and one year of experience working with the public.
Degrees, Licenses, and 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.