Mississippi
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Raleigh, North Carolina
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United States - Nationwide
Posted: 04-Feb-25
Location: Durham, North Carolina
Categories:
Internal Number: 254110
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 Work Performed
Obtain authorizations basedaccordance wi thestablishedpayment. Position responsible for high production generated accuratelyinAccurately complete patient accounts based on departmental protocol, Greet and assist visitors and patients. Explain policies and calculate and according to PRMO credit and collection policies. Implement appropriate insurance plan contracts and guidelines. Document billing systemExplain relationships with patients, coverage and actions.policies and procedures, considered out-of-network and receiving services at a reduced benefit and compliance with regulatory agencies, to include but not limited to pre-admission, admission, pre-registration, and registration functions. 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 forgovernmentfunding sources. Departmental coverage as well as payments payments appropriately for allpatients. Reconcile daily necessity of third-party sponsorship and process patients in accordancereimbursement.
Obtain all Prior Authorization Certification 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 theappropriate source of liability/payment. Admit, register pre-register patients with accurate patient demographic andfinancialdata. Resolve insurance claim rejections/denials and remedy expediently. Cash deposit. Evaluate diagnoses to ensure compliance with the LocalMedicareRe View Policy. Perform those duties necessary to ensure all accounts are processed accurately and efficiently. Compile departmental statistics for budget and reporting purposes. Collection actions and assist financiounsel ing. Determine with policy and procedure. Examine insurance policieallyre responsible persons in arranging payment. Make referrals for financialcsandoth er third-party sponsorship materials for sources of payment. Inform the physician of the patient's financial hardship. Complete the managed-care waiver form for patients. Update the billing system to reflect the insurance status of the patient. Refer patients to the ManufacturerDrug program as needed for procedures, and resolve problems. Gather necessary information to support the proper handling of inquiries and complaints. Assist riding to policy and procedure. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information requested and resolve issues relating to physicians, co-workers, and supervisors. Data, perform multiple tasks and work independently. Must be able to develop and maintain professional, service-oriented work. Must be able to understand a comply with policies and procedures.business processes or regulation. Requires working knowledge of compliance principles. Joballowsthe opportunity to work independently.
Minimum Qualifications
Duke is an Affirmative Action/Equal Opportunity Employer committed toproviding employment opportunity without regard to an indiv idual's age,color, disability, gender, gender expression, gender identit y, geneticinformation, national origin, race, religion, sex, sexual orie ntation,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 essential job f unctions thatrequire specific physical and/or mental abilities. Addition alinformation and provision for requests for reasonable accommodation wi llbe provided by each hiring department.
Education
Work requires knowledge of basic grammar and mathematic al principlesnormally required through a high school education, with som epostsecondary education preferred. Additional training or workingknowle dge of related business.
Experience
Two years experie nce workingin hospital service access, clinicalservice access, physicia n office or billing and collections. Or, anAssociate's degree in a healt hcare related field and one year ofexperience working with the public. O r, a Bachelor's degree and one yearof 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.
