Santa Clara, California
Morristown, New Jersey
Longmont, Colorado
Bay Pines, Florida
Colorado Springs, Colorado
Indiana
Lumberton, North Carolina
Helena, Montana
Posted: 03-Oct-25
Location: Durham, North Carolina
Categories:
Internal Number: 262022
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.
DUKE RALEIGH PRE-ADMISSION TESTING (Monday - Friday) 8AM -4:30PM
Occ Summary
Accurately compl ete patient accounts based on departmental protocol, policies and proced ures,and compliance with regulatoryagencies, to include but not limited topre-admission, admission, pre-registration and registration functions. Ensure all insurance requirements are met prior to patients' arrival and inform patients of their financial liability prior to arrival for servic es.Arrange payment options with the patients and screens patients for go vernment funding sources.
Work Performed
Analyzeinsu rance coverage and benefits for service to ensure timely reimbursement.O btain all Prior Authorization Certification and/or authorizationsas appr opriate. Facilitate payment sources for uninsured patients. Determineifp atient's condition is the result of an accident and perform completerese arch to determine the appropriate source of liability/payment.Admit,regi ster and pre-register patients with accurate patient demographic andfina ncial data. Resolve insurance claim rejections/denials andremedy expedie ntly. Calculate and collect cash payments appropriately for all patients . Reconcile daily cash deposit. Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy. Perform those duties necessaryto ensure all accounts are processed accurately and efficiently. Compile de partmental statistics for budgetary and reporting purposes. Explainbills according to PRMO credit and collection policies. Implement appropriate collection actions and assist financially responsible persons in arrang ing payment. Make referral for financial counseling. Determine necessity of third party sponsorship and process patients in accordance withpolic y and procedure. Examine insurance policies and other third partysponsor ship materials for sources of payment. Inform attending physicianofpatie nt financialhardship. Complete the managed care waiver form for patients considered out of network and receiving services arance status ofthe pa tient. Refer patients to the Manufacturer Drug prot a reducedbenefitleve l. Update the billing system to reflect the insugram as needed formedica tions. Greet and provides assistance to visitors and patients.Explain po licies and procedures, and resolves problems.and complaints. Assist with departmental coverage as requested. Obtain authorizations based on insu rance plan contracts and guidelines. Documentbilling system according to policy and procedure. Enter and update referrals as required.Communicat e with insurance carriers regarding clinical informationrequestedand to resolve issues relating to coverage and payment.
Knowledge, Skills and Abilities
Excellent communication skills,oraland writ ten. Ability to analyze data, perform multiple tasksand work independent ly. Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers andsuperviso rs. Must be able to understand and comply with policies and procedures.< /p>
Level Characteristics
Positionresponsible for high pr oduction generated accurately in accordance withestablished business pro cesses or regulation. Requires working knowledgeof compliance principles . Job allows the opportunity to work independently.
Minimum Qualifications
Duke is an Equal Opportunity Employer committed to provi dingemployment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, geneticinformati on, national origin, race, religion, sex (including pregnancyand pregnan cy related conditions), sexual orientation or militarystatus.
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Duke aspires to create a community built on collaboration,inno vation, creativity, and belonging. Our collective success depends onthe robust exchange of ideas-an exchange that is best when the richdiversity of our perspectives, backgrounds,and experiences flourishes.To achieve this exchange, it is essential that all members of thecommunity feel se cure and welcome, that the contributions of allindividuals are respected , and that all voices are heard. All members ofour community have a resp onsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University andDuke University Healt h System may include essential job functions thatrequire specific physic al and/or mental abilities. Additionalinformation and provision for requ ests for reasonable accommodation willbe provided by each hiring departm ent.
Education
Work requires knowl edge of basic grammar and mathematical principlesnormally required throu gh a highschool education, with somepostsecondary education preferred. Additional training or workingknowledge of related business.
Experience
Two years experience working in hospital service acce ss, clinicalservice access, physician office or billing and collections. Or, anAssociate's degree in a healthcare related field and one year ofe xperience working with the public. Or, a Bachelor's degree and one yearo f experience working with the public.
Degrees, Licensures, Certif ications
None required
Duke is an 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 (including pregnancy and pregnancy related conditions), sexual orientation or military status.
Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends onthe 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 essential job 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.