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Form of workAt 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.
REMOTE POSITION: Monday - Friday (1st Shift)
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.
Job description:
- Assist with the training and orientation of new employees
- Quality Reviews: Provide communication within 24 hours to staff regarding Error Feedback received by Quality Review and discuss overall monthly quality review scores with each staff member
- Complete monthly OER/productivity reports for each staff member
- Maintain attendance controller logs for each employee; monitor and approve PTO time off requests
- Complete API with accurate employee information
- Communicate changes in policy, payor updates, and procedures to staff as needed
- Prepare and discuss monthly, midyear, and yearly performance evaluations on each employee, with documentation to support, in a timely manner to meet the deadlines provided for each
- Coordinate, schedule, and communicate effectively with Manager promoting a positive and productive work team. Share organization, planning, and presentation of weekly team meetings as scheduled
- Set up and perform interviews; complete hiring process for open positions in a timely manner
- Adhere to and enforce the Duke Staff Handbook and complete Corrective Actions, where appropriate, in a timely manner with documentation; prepare review with Manager prior to completion
- Follow FMLA guidelines, when it applies to an employee situation
- Follow Injury Form requirements according to policy and procedure re and website instructions
- Follow Safety website instructions and monitor timely completion by employees on a monthly basis to ensure compliance
- Prepare all counseling and written documentation in a timely manner, with appropriate Performance Improvement Plans
- Monitor security access for all staff and inform management of any necessary updates in a timely manner
- Round with direct reports regularly per departmental policy
- Acts as resource to staff and responds to inquiries and questions in a timely manner
- Review and approve or deny adjustment requests following departmental policy and procedure
- Track, trend, and recommend solutions for preventable adjustments (timely filing, on authorized, etc.)
- Provide education and feedback to staff as needed for errors recognized during adjustment review
Accounts Receivable/Denial Monitoring Review:
- Review, analyze, and distribute aging A/R reports
- Trend and report questionable rejections
- Maintain and review high dollar balances and verify that the action taken previously was appropriate and will yield positive results
- Proactively identify changes required for third party billing and collections and coordinate with the claim team, charge processing, reimbursement and/or third-party to implement changes and train staff
- Notify Manager of any aging problems with supporting documentation of findings
- Participates in the development of operating goals and objectives for the unit; recommends, implements, and administers operating protocol and procedures to enhance operations
- Attends meetings and participates on committees, as assigned.
- Review, discuss, and/or suggest any Policy and Procedure changes necessary with your manager
- Make recommendations as needs are identified
- Actively participate in Work Culture initiatives based off quarterly and annual work culture scores and action plans.
Minimum Qualifications
Education
Work generally requires knowledge of clerical and accounting principles usually acquired through an associate degree in Accounting or a directly related field.
Strongly preferred: College degree or significant years of patient revenue cycle/process experience in lieu of college degree.
Experience
Work requires a minimum of 5 years of healthcare experience, with a focus on hospital billing and collections. Strongly preferred: five years of healthcare revenue cycle experience, ideally with Denials and Prior Authorization, front end, and back end experience.
Knowledge, Skills, and Abilities
- Experience in revenue cycle with a concentration in Accounts Receivable and denials
- Excellent communication skills, oral and written
- Ability to systematically analyze problems, draw relevant conclusions, and devise appropriate course of action
- Ability to analyze data, perform multiple tasks, and work independently
- Must be able to develop and maintain professional, service-oriented working relationships with senior leadership, patients, physicians, co-workers and employees
- Ability to work in a fast paced environment, with focus on team building
- Experience with supervising staff both onsite and remotely
- Experience with billing and collections; professional and hospital
System Experience:
Preferred: Masetro Care, Hyland/Onbase, Microsoft PowerPoint, FSS (Medicare Billing), Payer Portals, Lotus Notes
Required: Microsoft Word, Microsoft Excel
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.
