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.

Occ Summary

Accurately complete patient accounts based onlicy. Perform those duties necessary to ensure allaccounts are proces sedEvaluate diagnosesto ensure compliance with the LocalMedicare Review Podepartmental protocol,policies andprocedures, and compliance with re gulatory agencies, toinclude but not limited to pre-admission, admission ,pre-registrationand registration functions. Ensure all insurance requir ements are metprior to patients' arrival and inform patients of theirfin ancialliability prior to arrival for services. Arrange payment options w iththe patients and screens patients for government funding sources.

Work Performed

Analyze insurance coverage and benefits forservice to ensure timelyreimbursement. Obtain all Prior Authorization Certification and/orauthorizations as appropriate. Facilitate payment so urces for uninsuredpatients. Determine if patient's condition is the res ult of an accidentand perform complete research to determine the appropr iate source ofliability/payment. Admit, register and pre-register patien ts withaccurate patient demographic and financial data. Resolve insuranc eclaim rejections/denials and remedy expediently.Calculate andcollect ca sh payments appropriately for all patients. Reconcile dailycash deposit. accurately and efficiently. Compile departmentalstatistics for budgetary and reporting purposes.Explain billsaccording to PRMO credit and collect ion policies. Implement appropriatecollection actions and assist financially responsible persons inarranging payment. Make referral for financia l counseling. Determinenecessity of third party sponsorship and processp atients in accordancewith policy and procedure. Examine insurance polici es and other thirdparty sponsorshipmaterials for sources of payment.Inf orm attendingphysician of patient financial hardship. Complete the manag ed carewaiver form for patients considered out of network and receivings ervices at a reduced benefit level. Update the billing system toreflectthe insurance status of the patient. Refer patients to theManufacturervi sitors and patients. Explain policies andprocedures, and resolves probDr ug program as needed for medications. Greet andprovides assistancetolems . Gathers necessary documentation tosupport proper handling of inquiries and complaints. Assist withdepartmental coverage as requested.Obtain au thorizations basedon insurance plan contracts and guidelines. Document b illing systemaccording to policy and procedure. Enter and updatereferrals asrequired. Communicate with insurance carriers regarding clinicalinfo rmation requested and to resolve issues relating to coverage andpayment.

Knowledge, Skills and Abilities

Excellent communica tion skills, oral and written. Ability to analyzedata, perform multiple tasks and work independently. Must be able todevelop and maintain profes sional, service-oriented workingrelationships with patients, physicians, co-workers and supervisors.Must be able to understand and comply with p olicies and procedures.

Level Characteristics

Positio n responsible for high production generated accurately inaccordancewith established business processes or regulation. Requiresworking knowledge of compliance principles. Job allows the opportunityto work independentl y.

Minimum Qualifications

Duke is an Equal Opportunity Employer committed to provi dingemployment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, geneticinformati on, national origin, race, religion, sex (including pregnancyand pregnan cy related conditions), sexual orientation or militarystatus.

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Duke aspires to create a community built on collaboration,inno vation, creativity, and belonging. Our collective success depends onthe robust exchange of ideas-an exchange that is best when the richdiversity of our perspectives, backgrounds, and experiences flourishes.To achieve this exchange, it is essential that all members of thecommunity feel se cure and welcome, that the contributions of allindividuals are respected , and that all voices are heard. All members ofour community have a resp onsibility to uphold these values.

Essential Physical Job Functions: Certain jobs at Duke University andDuke University Healt h System may include essential job functions thatrequire specific physic al and/or mental abilities. Additionalinformation and provision for requ ests for reasonable accommodation willbe provided by each hiring departm ent.

Education

Work requires knowl edge of basic grammar and mathematical principlesnormally required throu gh a high school education, with somepostsecondary education preferred. Additional training or workingknowledge of related business.

Experience

Two years experience working in hospital service acce ss, clinicalservice access, physician office or billing and collections. Or, anAssociate'sdegree in a healthcare related field and one year ofe xperience working with the public. Or, a Bachelor's degree and one yearo f experience working with the public.

Degrees, Licensures, Certif ications

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.

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About Duke University Health System

As a world-class academic and health care system, Duke Health strives to transform medicine and health locally and globally through innovative scientific research, rapid translation of breakthrough discoveries, educating future clinical and scientific leaders, advocating and practicing evidence-based medicine to improve community health, and leading efforts to eliminate health inequalities.

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