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.
***$5000.00 Commitment Bonus (2 installments over 12 months in 6-month increments)
* Only new hires who have not worked for Duke University in the past 12 months (at the time of offer) are eligible to receive the sign-on bonus.
Duke Cardiology of Arringdon, South Durham, and Cary
Monday-Friday, 8:30-5:00, late-night rotation schedule, when needed.
Occ Summary
Accurately complete patient accounts based on departmental protocol, policies,policies and procedures and compliance with regulatory agencies, including but not limited to pre-admission, admission, pre-registration and registration functions. Ensure all insurance requirements are met prior to patients' arrival, and inform patients of their financial viability prior to their arrival for services. Arrange payment options with the patients and screen patients for government funding sources.
Work Performed
insurance coverage and benefits for service to ensure timely reimbursement. Obtain all prior authorization certifications 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 complete research to determine the appropriate source of liability or payment. admit, register, and pre-register patients with accurate patient demographics and financial data. Resolve insurance claim rejections and denials and remedy them expediently.
Calculate and collect cash payments appropriately for all participants. Reconcile the daily cash deposit. Evaluate diagnoses to ensure compliance with the Local Medical Review Policy. Perform those duties necessary to ensure all accounts are processed accurately and efficiently. Compile departmental statistics for budgetary and reporting purposes. Explain according to PRMO credit and collection policies. Implement appropriate collection actions and assist financially responsible persons in arranging payment. Make a referral for financial counseling. Determine the necessity of third-party sponsorship and process patients in accordance with policy and procedure. Examine insurance policies and other third-party sponsorship materials for sources of payment. Inform the attending physician of the patient's financial hardship. Complete the managed caregiver form for patients considered out of network and receiving services at a reduced benefit level. Update the bills to the manufacturer's drug program as needed for medication. Greet and pleading system to reflect the insurance status of the patient. Refer patient assistance to visitors and patients. Explain policies and procedures, and resolve problems. Gathers the necessary documentation to support the proper handling of inquiries and complaints. Assist with departmental coverage as requested.
Obtain authorizations based on insurance plan contracts and guidelines. Document the billing system according to policy and procedure. Enter and update referrals as required. Communicate with insurance carriers regarding the clinical information requested and resolve issues relating to coverage and payment.
Knowledge, skills, and Abilities
Excellent communication skills, oral and written. Ability to analyze data, perform multiple tasks, and work independently. Must be able to develop and maintain professional, service-oriented relationships with patients, physicians, co-workers, and supervisors.Must be able to understand and comply with policies and procedures.
Level Characteristics
Position responsible for high introduction generated accurately in accordance with established business policies or regulations. It requires a working knowledge of compliance principles. The job provides the opportunity to work independently.
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 businesses.
Experience
Two years of experience working in hospital service access, clinical service access, the 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, 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.
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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.