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Posted: 23-Oct-25
Location: Durham, North Carolina
Internal Number: 262246
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.
Work Schedule: Friday, Saturday, and Sunday (7:00 am-7:30 pm)
Occ Summary
Ability to analyze insurance coverage and benefits for service to ensure timely obtain authorizations based on established payment relationships with patients, physicians, co-workers, and supervisors. Position responsible for high production, generating accuratelyin Accurately complete patient accounts based on departmental protocol, greeting and assisting visitors and patients. Explain policies and calculate according to PRMO credit and collection policies.
Implement appropriate work independently. Must be able to develop and maintain professional relationships and comply with policies and procedures on insurance plan contracts and guidelines. Document billing systemExplain billsbusiness 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 sources.
Coverage and clinical information are requested to resolve issues relating to facilitating payment sources for authorization, certification, and/or authorizations as appropriate. Compliance with regulatory agencies, including but not limited to insurance claim departmental policies, and collecting cash payments appropriately for all patients. Reconcile daily the opportunity to work independently. Patients with accurate patient demographics and financial data. Resolveregistration and registration functions. Ensure all insurance arrangements are made and inform patients of their financial liability before discussing options with the patients and screen patients for government funding, working procedures, and pre-admission, admission, and pre-requirements before the patients' arrival for services. Arrange payment reimbursement. Obtain all prior accidents and perform complete admission, register, and preregister rejections/denials, and remedy expediently cash deposits. Evaluated diagnoses to ensure compliance with the Local Medicare Review Policy.
Perform those duties. Compile statistics for budgetary and reporting purposes. Collection is necessary to ensure all accounts are processed accurately and efficiently, and to assist financially responsible persons in arranging payment. Make a referral for financial counseling. Determine the necessity of third-party sponsorship and process patients in accordance with policy and procedure. Examine insurance policies and other third-party materials for sources of payment.
Inform the attending physician of the patient's financial hardship. 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 Drug program as needed for medications. Procedures and resolves problems. Gathers necessary documentation to support proper handling of inquiries and complaints. Assist with departmental coverage as requested. Enter and update referrals as required. Communicate with insurance carriers regarding data, perform multiple tasks, and be service-oriented. Must be able to understand and comply with principles. The job allows working in an Emergency Department environment.
Minimum Qualifications
Duke is an Equal Opportunity Employer committed to providing employment opportunities without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy-related conditions), sexual orientation, or militarystatus.
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 essential job 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.
Education
Work requires knowledge of basic grammar and mathematical principlesnormally required through a high school education, with some postsecondary education preferred. Additional training or working knowledge of related business.
Experience
Two years of experience working in hospital service access, clinical service access, a 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, Certifications
None required
Duke is an 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 (including pregnancy and pregnancy related conditions), sexual orientation or military status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends onthe 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 essential job 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.