REVENUE CYCLE SPECIALIST - OPERATIONAL STAFFING POOL
Duke University Health System
Location: Durham, North Carolina
Internal Number: 194968
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 Primary Care. 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 Dukeâ€™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.
Under generalsupervision, the Revenue Cycle Specialist provi despatient revenue management supportthrough all the different areas of the revenue cycle, to include but notlimited to Incoming Call Center, Bi lling and Collections, Cash Management andPayment Posting, Scheduling, P re-Registration and Charge Capture, Self-PayCollections, Credit Balance, Authorization Denials, Provider Enrollment,Support Services, and Revenu eManagement andCoding.
Assignments aretransactional and productivity based. Specificjob duties may include one or more of the following responsibilities in variousareas of the revenue cycle: answera nd resolve inbound inquiries and issuesregarding patient account stateme nts, explanation of benefits, balance due, andother patient and insuranc e inquiries, scheduling inpatient and outpatient appointments,pre-regist ration of patients prior to service, billing – sending out claims andpat ient statements for reimbursement, cash management and payment posting,a nalyze insurance coverage and benefits for service to ensure timelyreimb ursement, cash collections, attorney requests, refund letters,undistribu ted money, claim edits, paper claims, charge correction, creditbalancere view and processing.
Assignments May also includeoneor moreof the following, but not limited to:financial and tr end analysis work in areassuch as self-pay and account receivable;denial s review, appeals, andresolution; support services schedule template edi ting and building; reconciliationsof cash accounts and resolve outstandi ng balances; provider enrollment; supportin Revenue Management & Cod ing; Patient Account Analyst roles for variousdepartments, and special p rojects that require analysis and feedback, which mayinclude reallocatio n of revenue.
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 the IDX, Siemens Invision and Meditech patient account systems preferred. OR EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND EXPERIENCE
Degrees, Licensures, Certifications
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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.