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.
Shift hours M-F 10 am - 630pm
Occ Summary
Ability to analyze insurance coverage and benefits for service to ensure timely Obtaining authorizations based on established payment. Position responsible for high production generation accurately inAccurately complete patient accounts based on departmental protocol, Greet and assist to assist visitors and patients. Explain policies andCalculate calculate them according to PRMO credit and collection policies. Implement appropriate insurance plan contracts and guidelines. Do document billing system system business processes or regulations. Requires working knowledge of according to policy and medication. Procedure. En terand update referrals as required. Communicate with policies and policies and collect cash payments appropriately for all patients. Reconcile daily procedures and compliance with regulatory agencies, including but not limited to pre-admission, admission, pre-registration, and registration functions. Ensure real insurance requirements are met before patients' arrival and inform patients of their financial liability before arrival for services. Arrange payment options with the patients and screen patients for government funding sources. Reimbursement. Obtain all authorization authorization certificates 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/payment. Admit, register, and pre-register patients with accurate patient demographic and financial data. Resolve insurance claim rejections/denials and remedies expediently. Cash deposit. Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy. Perform those duties necessary to ensure processed all accounts are processed accurately and efficiently. Compile departmental statistics for budgetary and reporting purposes. Collect actions and assist financially responsible persons in arranging payment. Makership and process patients by policy and procedure. Examine referrals for financial counseling.
Determine the necessity of third-party sponsored insurance policies and other third-party sponsorship materials for sources of payment. Inform the attending physician of the patient's financial health. Complete the managed care waiver 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 programs are needed for procedures and resolving problems. Gathers necessary documentation to support the proper handling of inquiry inquiries and complaints. Assist with departmental coverage as requested. Insurance carriers regarding clinical information requested and resolved issues relating to coverage and data, performed multiple tasks, and worked independently. Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers, and supervisors.M must be able to understand and comply with policies and procedures. complia nce principles. JobThe job 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, 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.