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PRMO:, established in 2001, Patient Revenue Management Organization (PRMO) is a fully integrated, centralized revenue cycle organization supporting all of Duke Health, including Duke University Hospital, Duke Regional Hospital, Duke Raleigh Hospital, the Private Diagnostic Clinic, and Duke PrimaryCare. The PRMO focuses on streamlining the revenue cycle through enhanced management of scheduling, registration, coding, HIM operations, billing, collections, cash management, and customer service. The Mission of the PRMO is delivering quality service by enhancing the patient experience, providing financial security, and preserving Duke's reputation and mission of advancing health together. Our Vision is to be recognized as a world class innovative revenue cycle organization that values our people, patients and performance.
Duke University Health System - Patient Revenue Management Office (PRMO) seeks to hire an experienced Revenue Cycle Specialist who will embrace our mission of Advancing Health Together.
The Revenue Cycle Specialist role is to provide patient facing and back end support while floating through all revenue cycle departments.
Work with Patients to resolve outstanding billing issues
Analyze and resolve claim edits and claim denials to ensure proper processing by insurance carriers
Interact with insurance carriers to obtain approvals for procedures and medications
Work with revenue cycle teams to make charge corrections to claims prior to submission
The Revenue Cycle Specialist will provide coverage and serve as a temporary resource in various areas of the revenue cycle. Specific assignments will be managed by PRMO Operational Staffing Pool office. Under general supervision, the Revenue Cycle Specialist provides patient revenue management support throughout the revenue cycle, to include but not limited to: Incoming Call Center, Billing and Collections, Cash Management and Payment Posting, Scheduling, Pre-Registration and Charge Capture. The Revenue Cycle Specialist will initiate and develop relationships with customers in order to gather and process information or resolve issues in order to receive accurate reimbursement and optimize internal and external customer satisfaction. Level I :Level I assignments are transactional and productivity-based. Specific job duties may include one or more of the following: Answer and resolve in bound inquiries and issues regarding patient account statements, explanation of benefits, balance due, and other patient and insurance billing scenarios; Billing- sending out claims and patient statements for reimbursement; Scheduling inpatient and outpatient appointments, pre-registration of patients prior to service; Cash management and payment posting; Charge correction, credit balance review and processing, and collection of accounts.
Level Characteristics: Ability to work in a stressful environment and tactfully handle sensitive issues; ability to present a calm, professional manner and to tolerate a wide range of working conditions and personalities; ability to multitask; ability to maintain a sense of order in a busy environment; ability to provide good internal and external customer relations. Advanced knowledge of revenue cycle operations Requires good communication skills, both written and verbal. Understands the impact of patient registration on the financial revenue cycle. Requires knowledge of patient accounting systems applications.
Work requires knowledge of basic grammar and mathematical principles normally required through a high school education. Completion of a bachelor's degree program in accounting or business related field preferred.
A minimum of five years' experience in healthcare revenue cycle operations or support is required. Working knowledge of Epic. OR EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND EXPERIENCE
Degrees, Licensures, Certifications
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.
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.