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.
Plans directs, and coordinates activities of the functional unit managed and with other regulatory performance issues. Plans daily workflow and work assignments within the work unit. Reviews work queues daily to identify daily priorities, including identification and resolution of problems with achieving targets; adjust staff work assignments as needed. Reviews claim denials and rejections about coding and medical necessity and, when necessary, implements corrective action plans, such as educational programs, to prevent similar denials and rejections from recurring.
Maintains and applies knowledge of State and Federal Laws and other requirements applicable to work units Centers for Medicare and Medicaid Services of UHCo Health Information Portability and Accountability Act of North Carolina State Privacy Statutes of Joint Commission Standards of North Carolina State requirements for record content, management, retention, and destruction. Assures that key metrics for quality, timeliness, and customer satisfaction are met Productivity, quality Manage and Supervise Staff In conjunction with the Sr. Manager, recruits, selects, orients and trains new staff.
Monitors staff achievement of productivity and quality expectations associated with unit tasks. Recommends corrective action as needed to address variances from standards, including adherence to organizational policies. Conducts monthly rounding with staff to facilitate a positive work culture that encourages 360-degree communication and timely and effective problem-solving. Recommends performance standards for staff, and in collaboration with the Sr.Manager, completes Annual Performance Reviews. Conducts Overall Effectiveness Ratings (OER) reviews monthly and reviews results for staff, identifying appropriate action plans as needed. Ensures that the work unit is appropriately staffed with qualified individuals
who are sufficiently trained to meet departmental and organizational expectations.
Approves time off; maintains employee timekeeping; maintains personal files. Serves as the technical expert for staff questions, problems, and difficult customersituationsCommunication and Collaboration. Daily interactions with customers within the HIM Department, within entities served, departments, medical staff, and other customers Billing, HB Coding, CDM, Revenue Managers, Compliance Department. Collaborates with DHTS to problem-solve system issues, including logging issues in Service Now; performing testing; identifying reporting needs and educating others when system changes are implemented Maintenance, testing, and education relative to coding and NCD updates. Participates in the creation and execution of educational initiatives associated with HIM strategies, including but not limited to the Use of Maestro Care, 3MEncoder, 3m360, SSI, and CAC. Effectively communicates verbally and in written form,(including statistical reports) updates to Sr. Manager and Director regarding trending and other operations of the work unit, status, and staff issues other. Performs other related duties incidental to the work described herein and performs related work as required.
BS Health Information Management, Health Informatics, Health preferred. Administration, Finance, or related field. A Master's degree in Business Administration or Health Administration is
Six years of experience in the healthcare industry is required, two of the six years are supervising or coordinating coding activities.
Degrees, Licensures, Certifications
Registered Health Information Administrator (RHIA), Registered Health Information Technician (RHIT), Certified Coding Specialist (CCS), or Certified Professional Coder (CPC).
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