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.
PRN: Saturday and Sunday. 8 a.m.–4:30 p.m. DUH North Admissions
Occ Summary
Ability to analyze insurance coverage and benefits for service to ensure timely obtaining of authorizations based on established payment.Position responsible for high production generated accurate and complete patient accounts based on departmental protocol, Greets and assists visitors and patients. Explain policies and calculate them according to PRMO credit and collection policies. Implement appropriate insurance plan contracts and guidelines. Document the billing system and explain bills, business processes, or regulations. It requires working knowledge according to policy and clinical information requested to resolve issues relating to rejections/denials and remedy them expediently.insurance carriers regarding procedures. Enter and update referrals as required. Communicate with and collect cash payments appropriately for all patients. Reconcile daily policies and procedures and compliance with regulatory agencies, including but not limited to admission, pre-registration, and registration functions.
Ensure all insurance requirements are met prior to patients' arrival, and inform patients of their financial liability prior to their arrival for services. Arrange payment options with the patients and screen patients for reimbursement from government funding sources. Obtain all prior authorization certifications and 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/payment. Admit, register, and pre-register patients with accurate patient demographic and financial data. Resolve insurance claim diagnoses to ensure compliance with the Local Medicare Review Policy. cash deposit. EvaluateP forms those duties necessary to ensure all accounts are processed accurately and efficiently.
Compile departmental statistics for budgetary and reporting purposes. 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' requests 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 billing system to reflect the insurance status of the patient. Refer patients to the manufacturer's drug program as needed for medications and procedures, and resolve problems. Gathers the necessary documentation to support the proper handling of inquiries and complaints. Assist with departmental coverage as requested, perform multiple tasks, and work independently. Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers, and supervisors. Must be able to understand and comply with policies and procedures.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'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. 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.
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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