REVENUE CYCLE SPECIALIST - OPERATIONAL STAFFING POOL
Duke University Health System
Location: Durham, North Carolina
Internal Number: 167802
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 (PR MO) 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 b ack 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 pro cessing by insurance carriers
Interact with insurance carriers t o obtain approvals for procedures and medications
Work with reve nue 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 providespatient revenue management support throughout the revenue cycle, to inc lude but not limited to: Incoming Call Center, Billing and Collections, Cash Management and Payment Posting, Scheduling, Pre-Registration and Ch arge Capture. TheRevenue Cycle Specialist will initiate and develop rel ationships with customers in order to gather and process information or resolve issues in order to receive accurate reimbursement and optimize i nternal and external customer satisfaction. Level I :Level I assignments are transactional and productivity-based. Specific job duties may inclu de one or more of the following: Answer and resolve in bound inquiries a nd 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; Schedulin g inpatient and outpatient appointments, pre-registration of patients pr ior to service; Cash management and payment posting; Charge correction, credit balance review and processing, and collection of accounts.
Level Characteristics: Ability towork in a stressful environmen t and tactfully handle sensitive issues; ability to present a calm, prof essional manner and to tolerate a wide range of working conditions and p ersonalities; ability to multitask; ability to maintain a sense of order in a busy environment; ability to provide good internal and external cu stomer relations. Advanced knowledge of revenue cycle operations Require s good communication skills, both written and verbal. Understands the im pact of patient registration on the financial revenue cycle. Requires kn owledge of patient accounting systems applications.
Work requires knowledge of basic grammar and mathematical princ iples normally required through a high school education. Completion of a bachelor's degree program in accounting or business related field prefe rred.
A minimum of five years' experience in healthcare revenue cycle operations or support is r equired. Working knowledge of Epic. OR EQUIVALENT COMBINATION OF RELEVAN T EDUCATION AND EXPERIENCE
Degrees, Licensures, Ce rtifications
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 knowledgeof the IDX, Siemens Invision and Meditech patient account systems preferred. 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.
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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.