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.

Friday-Sunday 7:00am-7 :30pm WEO Shift differential

Occupat ionalSummary

Accurately complete patient accounts based on departmental protocol, pol icies and procedures, and compliancewith regulatory agencies, to inc lude but not limited to pre-admission, pre-registration and d-registration functions.
Ensure all insuran ce requirements are met prior to patients' arrival and inform patien ts of their financial liability prior to arrival for services.
Arrange payment optionswith the patients and screens pati ents for government funding sources.

Work Perfor med

Analyze insurance coverage and be nefits for service to ensure timely.
Obtain authorization-based payments based . on insurance plan contracts and guidelines.< /span>
Documentbilling system.
Expl ain bills provides assistanceto visitors and patients.
< li>Explain policies anddepartmental coverage as requested.
Calculate and according to PRMO credit and collection poli cies.
Implement appropriate collect cash payme nts appropriately forall patients.
Reconcile the daily necessity of third-party partysponsorship and process patients in accordance ordance reimbursement.
Obtain all Prior authorization certifications and/or authorizations as appropriate.
< li>Facilitate payment sources for uninsured patients.
Determine if the patient's condition is the result of an accide nt and perform completeresearch to determine the appropriate source of l iability/payment.
Admit, register and pre-regis ter patients withaccurate patient demographic and financial data.
Resolve insurance claim rejections/denials and remedy expediently.
Evaluate diagnoses to ensure complianc e with the Local Mcessary toensure all accounts are processed accurately andefficiently.
Perform those duties.
Compile departmentalstatistics for budgetaryand reporting purpose.
collection actions andassist financially re sponsible persons inarranging payment.
Makeref erral for financialcounseling.
Determine with p olicy and procedure.
Examine insurance policie s and other third-party sponsorship materials forsources of payment.< /span>
Inform the attending physician of the patient's financial hard ship.
Complete the managed care waiver form fo r patients considered outof network and receiving services at a redu ced benefit level.
Update the billing system t o reflect the insurance status of the patient.
Ref er patients to theManufacturer manufacturer's drug program as needed for medication.
Greets and procedures and resolves problems .
Gathers necessarydocumentation to support the processing of inquiriesand complaints.
Assis t with according topolicy and procedure.
Enter and update referrals as required.
Communicate with insurance carriersregarding regarding clinical information requested and to resolve issues relating to coverage

Knowledge, Skills, and Abilities

Ex cellent communication skills, oral and written.
Ability toanalyze relationships with patients, physicians, co-workers and supervisors. data, perform multiple tasks and work independently .
Must be able to develop and maintain professional, service-oriented working,
Must be able to und erstand and comply with policies and procedures.

Level Ch aracteristics

Position responsible for high production generated accuratelyin accordance with established business processes or regulations.

Requires working knowledge of compliance principles. Job allows the opportunity to work independently.

Accurately complete patient accounts based on departmental protocol, policies and procedures and comply with withregulatory agencies, to include but not limited to pre-adm ission, admission, pre-registration, and registration functions. Ensureall insurance requirementsare met prior to patientsarrival and inform patie nts of their financial viability prior to their arrival for services. Arrange p ayment options with the patients and screens patients for government fundi ng sources.

Knowledge, Skills and Abilities

Exc ellent 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 working relationships with pati ents, physicians, co-workers and supervisors.Must be able to understand and comply with policies and procedures.

Level Characterist ics

Position responsible forhigh production generated accurately in accordance with established business processes or regulations. Require working knowledge of compliance principles.Job allows the opportunity to work independently.

Minimum Qualifications

Education

Work requires knowledge of basic grammar and mathematicalprinciples 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 serviceaccess, 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, 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.