Durham, North Carolina
Durham, North Carolina
Durham, North Carolina
Durham, North Carolina
Durham, North Carolina
Morrisville, North Carolina
Cary, North Carolina
Fletcher , North Carolina
Fayetteville, North Carolina
Durham, North Carolina
Raleigh, North Carolina
Posted: 12-Jul-25
Location: Durham, North Carolina
Internal Number: 258120
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 hours: Friday-Sunday 12p-6P
Job Summary
Ability to analyze insurance coverage and benefits for services to ensure timely filing. The position is responsible for high production, generating accurate, complete patient accounts based on departmental protocol. Greet and assist visitors and patients. Explain policies and collect according to PRMO credit and collection policies. Implement appropriate insurance plan contracts and guidelines. Ability to analyze insurance coverage and benefits for services to ensure timely filing. The position is responsible for high productivity, generating accurate and complete patient accounts based on departmental protocol, greeting and assisting visitors and patients. Explain policies and collect according to PRMO credit and collection policies. Implement appropriate insurance plan contracts and guidelines. Document in the bilingual system. Explain the bill's relationships with patients, business processes, or regulations.
Requires working knowledge of collection actions and assisting financially responsible persons in arranging payment. Ensure all 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 for our services. Departmental coverage is collecting cash payments appropriately from all patients. Recognized the necessity of third-party sponsorship and processed patients through reimbursement. Obtain all prior authorization certifications 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.
Evaluate diagnoses to ensure compliance with the local Medicare review policy. Perform those duties necessary to entrench statistics for budgetary and reporting purposes. Ensure all accounts are processed accurately and efficiently. Compile departure policies and other third-party sponsorship materials for sources of payment. Informing the 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's Drug programs are needed for procedures and to resolve problems. Gathers necessary documentation to support proper handling of inquiries and complaints. Assist according to policy and procedure. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage and physicians, coworkers, and supervisors. Data, perform multiple tasks, and work independently. Must be able to develop and maintain a professional, service-oriented attitude and must be able to understand and comply with policies and procedures. Compliance principles.
The job allows the opportunity to work independently.
Explain the bills' relationships with patients, business processes, or regulations. Requires working knowledge of collection actions and assists financially responsible persons in arranging payment. Ensure all 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. The departmental coverage collects cash payments appropriately for all patients. Reconcile the necessity of third-party sponsorship and process patients by reimbursement. Obtain all prior authorization certifications 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. Evaluate diagnoses to ensure compliance with the local Medicare review policy. Perform those duties necessary to ensure all accounts are processed accurately and efficiently. Compile departmental statistics for budgetary and reporting purposes. Examine insurance policies and other third-party sponsorship 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 procedures and resolve problems. Gathers necessary documentation to support proper handling of inquiries and complaints. Assist according to policy and procedure. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage and physicians, co-workers, and supervisors. Data, perform multiple tasks, and work independently. Must be able to develop and maintain professional, service-oriented skills and must be able to understand and comply with policies and procedures. Compliance principles. The job allows the opportunity to work independently.
Minimum Qualifications
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 militarystatus.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on onthe robust exchange of ideas-an exchange that is best when the rich richdiversity 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 allindividuals are respected , and that all voices are heard. All members of ofour community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University and andDuke 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 principles, normally 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, 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 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.