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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

Answer and respond to all PRMO-related customer i >ssues that are receivedby way of telephone, in person and/or writing, m eeting customer anddepartmental goals and objectives.

Work P erformed

Answer and resolveall inbound inquiries and issues rega rding patientaccount statements, bad debt write off's, explanation of be nefits,balance due, and other patient and insurance billing related scen arios.Analyze the patient's problem or issue that is presented by collec tinginformation and data and conducting thorough research of the IDX pat ientaccounting systems, Hyland Onbase for documents that may have beenim aged (EOBs, statements, admitting documentation, patientcorrespondence, etc.), Passport or BlueE for eligibility, researchingpayor websites and/ or contacting the payor is needed. Analyzeinformation for an appropriate solution and take the necessary actionneeded to resolve the issue.Follow through on all customer issues promptly and accurately untilcompletion.O pen work items include issues that are tracked via PCSworkfiles, the cus tomerservice follow up database and paper workfiles.Thoroughly updatean d document PCS notes or system comment fields withall information pertai ning to an inquiry (i.e. questions, answers,actions, follow up itemsrequ ired).Communicate with the patient, physicians, collection agency, inter naldepartments and all other internal and external customers in aprofess ional, courteous, and respectful manner.Post customer service adjustment s when supported by policy, contractualadjustments and other adjustments as deemed necessary followingappropriate write off guidelines.Update in surance information and file and/or appeal claims withinsurance companie s according to department guidelines. Take appropriateactions to bill in surance companies or patients with correctedinformation including accept ing and inputting secondary insuranceinformation into the system andfili ng claims.Coordinate patient refund requests with the credit balancedepa rtment.Research EOB?s and payment detail to determine if a patiente fina ncial counseling to patients, guarantors, and attorneysregarding crefund isnecessary or determine the nature of the credit balance.Providharges for health care services. Validate that charges arecorrect and request m edical review and audit when necessary.Discuss and establish payment pla ns for patients that require extendedterms to pay off a balance.Produce itemized statements. Mail and provide itemized statements topatients when requested.Assist patients that are requesting charity care by conducti ng aninitial screening and sending or providing that patient a copy of t hecharity care application when requested. Provide feedback regardingsta tus of the application when requested from a patient.Obtain and post cre dit card payments for accounts including authorizedsettlements within de partmental guidelines. Follow department policynecessary for charge corr ections, transferring credits, coding changes,service and chargedisputes , and locate payments.Following appropriate policy, update all system in formation toaccessible fields to include correct registration informatio n, address,telephone numbers, guarantor information, employer informatio n,insurance information, etc.Identify trends in system problems,training or procedural concerns.Make recommendations and provide feedback regard ing corrective andpreventive action to the supervisor or manager. Track the problem toensure the inquiry is completed through PSC workfiles or the follow updatabase.Adhere to all HIPAA and confidentiality guidelines. Work with a diverse group of internal and external customers (i.e.attorn eys, insurance companies, state agencies, physician offices,collection a gencies, etc).Work as a team membertowards common goals.Prepare and /or assist with special reports as requested by management.Adhereto a sched ule to ensure customer availability and demonstrateflexibility to schedu les according to patient or call volume or staffingneeds.Perform other related duties incidental to the work described herein.

Knowl edge, Skills and Abilities

Analytical and problem-solving skillsStro ng organizational skills with the ability to multi-task and followthroug h on outstanding issuesStrong computer skills with knowledge of MS Word, MS Excel and e-mailExcellent interpersonal skills with the ability to c ommunicateeffectively both orally and in writingAbility towork well with others - strong teamwork skillsMust be flexible and ableto function in awork environment where workand schedules may change tomeet the needs o f the patientDemonstrated ability to work well withcustomers and deliver excellentcustomer serviceAbility to control and manage a phone callBi-l ingual preferredKnowledge of DUHS billing preferred

Minimum Qualifications

Education

Work requires knowledge of basic grammar and mathematical principles normally required through a high school education. Two-year college degree preferred.

Experience

A minimum of three years direct customer service or call center preferred. operations experience is required. A healthcare background working in medical billing, collections, insurance claims processing, coding, registration,working in a medical organization, or like experience in the fields of education, training, training development, is highly Inbound to outbound call center experience preferred. Working knowledge of Maestro Care system preferred.

Degrees,Licensures, Certifications

N/A

 

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.

 

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