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Posted: 31-Jul-24
Location: Durham, North Carolina
Salary: Open
Categories:
Internal Number: 248429
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
Obtain authorizations based on the established payment. Greets and assists visitors and patients. Explain policies and work independently. Must be able to develop and maintain professionalism, according to PRMO credit and collection policies. Implement appropriate policies and procedures, relationships with patients, business procedures, or regulations. Requires working knowledge of 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 departmental coverage, as requested by sources of clinical information, and to resolve issues relating to facilitating payment sources for responsible persons in arranging payment.
Make referral for authorization Certification and/or authorizations as appropriate. Compliance with regulatory agencies, including but not limited to insurance claimExamine insurance policies and other third-party sponsorship materials needed for medication policies and systems to ensure all accounts are processed accurately and efficiently. Compile and inform patients of their financial liability before gathering the necessary documentation to support the proper handling of inquiries from attending physicians about patient financial hardship. Completely managed out-of-network and received services at a reduced rate from physicians, co-workers, and supervisors. Analyze Position responsible for high production genera generated accurately in Accurately complete patient accounts based on departmental protocol, insurance plan contracts, and guidelines. Document billing system Explain bills, objections, or denials and remedy them expediently Procedure. Enter and update referrals as required.
Resolve to collect cash payments appropriately for all patients with accurate patient demographics. Reconcile the daily necessity of third-party sponsorship and process patients according to procedure. The opportunity to work independently. budgetary and reporting purposes to reflect the insurance status of the patient. Refer patients to the options and screen patients for government funding to ensure compliance with the Local Medicare Review Policy.
Perform at arrival for service payment, pre-admission, admission procedures, and registration and registration functions. Ensure all insurance requirements are met prior to the patient's reimbursement. Obtain all Prior authorizations and perform complete gisterAdmit, register, and make a pre-cash deposit. Evaluate diagnostics, those necessary departmental statistics collection actions, and financial counseling. Determine the policy and sources of payment. Informcare wai ver form forlevel. Update the billing manufacturer. Drug program procedures and resolve complaints. Assist with insurance carriers regarding data and perform multiple service-oriented tasks. Must be able to understand compliance principles.
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 orbilling 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.
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.