Location: Durham,NC, USA
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
Answer and respond to all PRMO- related customer issues that are receivedby way of telephone, in person and/orwriting,meeting customer anddepartmental goals and objectives.
WorkPerformed
Answer and resolveall inbound inquiries an d issuesregarding patientaccount statements, bad debt write off's, expla nationofbenefits,balance due, and other patient and insurance billing re latedscenarios.Analyze the patient's problem or issue that is presentedbycollectinginformation and data and conducting thorough research of the IDXpatientaccounting systems, Hyland Onbase for documents that may have beenimaged (EOBs, statements, admitting documentation, patientcorrespon dence,etc.), Passport or BlueE for eligibility, researchingpayor website sand/or contacting the payor is needed. Analyzeinformation for an approp riatesolution and take the necessary actionneeded to resolve the issue.F ollowthrough on all customer issues promptly and accurately untilcomplet ion.Open workitems include issues that are tracked via PCSworkfiles, th ecustomer service follow updatabaseand paper workfiles.Thoroughly update anddocument PCS notes or system comment fields withall information perta ining to an inquiry (i.e. questions, answers,actions, follow up itemsreq uired).Communicate with the patient, physicians, collection agency, inte rnaldepartments and all other internal and external customers in aprofes sional, courteous, and respectful manner.Post customer service adjustmen tswhen supported by policy, contractualadjustments and other adjustments as deemed necessary followingappropriate write off guidelines.Updateinsu rance information and file and/or appeal claims withinsurance companiesa ccording to department guidelines. Take appropriateactions to billinsura nce companies or patients with correctedinformation including accepting and inputting secondary insuranceinformation into the system andfilingcl aims.Coordinate patient refund requests with the creditbalance departmen t.Research EOB?s and paymentdetail to determine if a patientrefund isnec enseling to patients, guarantors, and attorneysregarding charges forheal tssary or determine the nature of the credit balance.Provide financialco uh care services. Validate that charges arecorrect and request medical r eview and audit when necessary.Discuss and establish paymentplansforpati ents that require extendedterms to pay off a balance.Produce itemized st atements. Mail and provide itemized statements topatientswhen requested.Assist patients that are requesting charity care by conducting aninitial screening and sending or providing that patient a copy of thecharity car eapplication when requested. Provide feedback regardingstatusof the appl ication when requested from a patient.Obtain and postcredit cardpayments for accounts including authorizedsettlements withindepartmentalguideline s. Follow department policynecessary for charge corrections, transferrin g credits, coding changes,service and chargedisputes, andlocate payments .Following appropriate policy, update all systeminformation toaccessible fields to include correct registration information, address,telephonenu mbers, guarantor information, employer information,insuranceinformation, etc.Identify trends in system problems,training or procedural concerns. Make recommendations and provide feedback regarding corrective andpreven tive action to the supervisor or manager. Track the problemtoensure thei nquiry is completed through PSC workfiles or the follow updatabase.Adhere to all HIPAA and confidentiality guidelines.Work with adiverse groupof internal and external customers (i.e.attorneys, insurance companies,sta te agencies, physician offices,collection agencies,etc).Work as ateam me mber towards commongoals.Prepare and/or assistwithspecial reports as req uested by management.Adhereto a schedule to ensure customer availability and demonstrateflexibility to schedules according topatient orcallvolum e or staffingneeds.Perform other related duties incidental tothe work de scribed herein.
Knowledge, Skills andAbilities
Analyt ical and problem-solving skillsStrong organizational skills with the abi lity to multi-task and followthrough on outstanding issuesStrong compute r skills with knowledge of MSWord, MS Excel ande-mailExcellent interpers onal skills with the ability to communicateeffectively both orallyand in writingAbility towork well with others- strong teamwork skillsMust be f lexible and ableto function in a workenvironment where workand schedules may change tomeet the needs ofthe patientDemonstratedability towork wel l with customers anddeliver excellentcustomer serviceAbility tocontrol a nd manage a phone callBi-lingualpreferredKnowledge of DUHS billing prefe rred
Minimum Qualifications
Education
Work requires knowledge of basic grammar and mathematical principles normally required through a high school education. Two-year college degree preferred.
Experience
A minimum of three years direct customer service or call center preferred. operations experience is required. A healthcare background working in medical billing, collections, insurance claims processing, coding, registration, working in a medical organization, or like experience in the fields of education, training, training development, is highly Inbound to outbound call center experience preferred. Working knowledge of Maestro Care system preferred.
Degrees, Licensures, Certifications
N/A
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.
Nearest Major Market: Durham
Nearest Secondary Market: Raleigh