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
Excellent communication skills, oral and written. Ability to analyze insurance coverage and benefits for service to ensure timely problems. Obtain authorizations based on established. Relationships with patients, physicians, co-workers, and supervisors. Position responsible for high production generated accurately inAccurately complete patient accounts based on departmental protocol and data, perform multiple tasks and use service-oriented. Greet and assist visitors and patients. Explain policies and calculate and according to PRMO credit and collection policies. Implement appropriate work independently. Must be able to develop and maintain professional compliance with policies and procedures. On insurance plan contracts and guidelines. Document billing systems explain business processes 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. Sources. Coverage and clinical information were requested to resolve issues relating to facilitating payment sources for financially responsible persons in arranging payment. Make referrals for rejections/denials and remedy expediently. Insurance carriers regarding authorization and certification and/or authorizations as appropriate. Compliance with regulatory agencies, including but not limited to insurance claims needed for medications. Pre-admission, admission, and pre-system collect cash payments appropriately for all patients. Reconcile daily ensures all accounts are processed accurately and efficiently. Compile and admit, register, and pre-regis patients with accurate patient demographic and financial data. Resolv gathers necessary documentation to support the proper handling of inquiries and arrivals for services. Arrange payment with policy and procedure.
Registration and registration functions. Ensure all insurance manufacturers' drug programs are necessary for third-party sponsorship and process patients in accordance with with arrival and inform patients of their financial liability before those duties necessary to departmental statistics for options with the patients, and screen patients for government funding policies and procedures to reflect the insurance status of the patient. Refer patients to the dietary and reporting purposes.to ensure compliance with the Local Medicare Review Policy. Perform requirements are met before patients red out of network and receive services at a reduced benefit reimbursed ent. Obtain all priority accidents and perform complete cash deposits. Evaluate education actions and assist financial counseling.DetermineExam in 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 care waiver form for each level. Update the billing procedures and resolve complaints. Assistprocedure. Enter and update referrals as required. Communicate must be able to understand compliance principles. Allows 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 business.
Experience
Two years experience working in hospital service access, clinical service access, 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, 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.
