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. ONSITE POSITION: (Monday - Friday: 11:00am - 7:30pm) General Responsibilities and Task: Gen Code Test Billing: Analysis of lab test orders in relation to contracts with external labs for billing and application of CMS rules and contractual obligations. Ensure information provided by Referral Lab Technologists is correct (QA billing, in formation provided with requisitions, such as patient insurance, date, etc. Ensure correct price and CPT codes for the test that has been ordered ). Applying CMS rules for billing determination. Ensure correct billing information is provided to external laboratories. Ensure correct account information is included for claims. Enter the appropriate CPT codes and prices for Gen Code test billing using EPIC work ques. HB and PB Claim Edits: Clear 15 PB an d2 HB Clinical Lab claim edits to ensure correct and timely billing for tests to reduce the risk of denials and unexpected bills for the patient. Other:
- Perform prior authorizations on Molecular tests for UH, BCBS, Tricare.
- Prepare spreadsheet with new Referral Lab Molecular test s for the UHC registry for prior authorizations and maintain test accuracy of the registry.
- Perform price estimates on Ge n Code tests for Duke Clinics throughout the Health System.
Minimum Qualifications: 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 experience working in hospital access, physician office or billing and collections or an equivalent combination of relevant education and/or experience.
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.