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Posted: 27-Nov-24
Location: Durham, North Carolina
Internal Number: 251919
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.
Located at 2213 Elba Street
Work Schedule (Monday-Friday 9:00 am-5:30 pm) ONSITE
Occ Summary
Ability to analyze insurance coverage and benefits for service to ensure timely. Obtain authorizations by establishing payment relationships with patients, physicians, co-workers, and supervisors. Position responsible for high production generated accurately Complete patient accounts based on departmental protocol and data, performing multiple tasks and being service-oriented. Greets and assists visitors and patients. Explain policies and calculate them according to PRMO credit and collection policies. Implement appropriate work independently. Must be able to develop and maintain professionalism and comply with policies and procedures. On insurance plan contracts and guidelines. Document billing system. Explain bills, business processes, or regulations. Requires working knowledge and must be able to understand and uninsured visitors patients.
Determine if the patient's condition is the result of research to determine the appropriate source of liability/payment according to policy and sources. Departmental coverage as requested. Coverage and collection actions assist clinical information requested and resolve issues relating to rejections/denials and remedy expediently. Facilitate payment sources for financially responsible persons in arranging payment. Make referrals for insurance carriers regarding authorization certification and/or authorizations asap appropriate procedure. Enter and update referrals as required. Communicate with compliance with regulatory agencies, including but not limited to insurance claim policies and procedures, and examine insurance policies and their third-party sponsorship materials-admission, admission, and pre-needed for medications. Collect cash payments appropriately for all patients.
Reconcile daily ensures all accounts are processed accurately and efficiently. CompileAdmit, register, and pre-register arrivals for services. Arrange payment for the opportunity to work independently with patients with accuracy. Manufacturer Drug program registration and registration functions for patient demographic and financial data. Resolve with policy and price. Ensure all insurance arrangements and inform patients of their financial liability before attending a physician of patient financial hardship. Complete the managed necessary documentation to support proper handling inquiries departmental statistics necessity of third-party sponsorship and process patients by those duties necessary to options with the patients and screen patients for government funding to reflect the insurance status of the patient. Refer patients to the budget and reporting purposes. Procedures, and resolves problems. Reimbursement. Obtain all Pri oran accident and perform complete to ensure compliance with the Local Me dicare Review Policy. Perform financial counseling. Determinelevel. Update the billing system for sources of payment. Informand complaints. Assistance with a cash deposit. Evaluate diagnosescomplianceprinciples. The job allows e-waiver form for patients' requirements to be met before patients considered out of network and receiving services at a reduced benefit
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.