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 primarycareThe prmo focuses on streamlining the revenue cycle through enhanced management of scheduling, registration, coding, him operations, billing, collections, cash management, and customer serviceThe 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 togetherOur vision is to be recognized as a world class innovative revenue cycle organization that values our people, patients and performance.
This position is 100% remote
Responsible for accurate and complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to pre-admission, admission, pre-registrationand registration functionsEnsure all insurance requirements are met prior to patients` arrival, and inform patients of their financial liabilityArranges payment options with the patients and screens patients for government funding sourcesThis is position has high customer service with our payors and physicians by phone and requires excellent customer service skillsThis position is very similar to the financial care counselorThis position completes all preliminary workThe financial counselor completes the work when the patient arrives.
Analyze insurance coverage and benefits for service to ensure timely explain billing to patients obtain authorizations based uninsured patientsDetermine if patient`s condition is the result of departmental coverage as requestedReimbursementObtain all pac and/or authorizations as appropriateFacilitate referral to financial services for payment sources for an accident, performing complete research to determine the appropriate source of liability/paymentSchedules and pre-register patients, correcting as necessary all patient demographic and financial dataResolve insurance claim rejections/denials and remedy expedientlyCall patients to remind them to bring balances due, co-pays, co insurance and deductibleEvaluate diagnoses to ensure compliance with the local medicare review policyPerform those duties necessary to ensure all accounts are processed accurately and efficientlyPromote and maintain excellence in customer serviceAccording to prmo credit and collection policies, when discussing insurance with patientsImplement appropriate collection actions and assist financially responsible persons in arranging paymentMake referral to financial services representative for counselingDetermine necessity of third party sponsorship and process patients per policy and procedureExamine insurance policies and other third party sponsorship materials for sources of paymentInform attending physician of patient financial hardshipUpdate the billing system to reflect the insurance status of the patientProvides timely and effective customer service to internal customersAssist with on insurance plan contracts / guidelines, document in billing system per policy and procedureEnter and update referrals as requiredCommunicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage and payment for specific patients and benefits.
Knowledge, skills and abilities
Excellent communication skills, oral and writtenAbility to analyze relationships with patients, physicians, co-workers and supervisorsData, perform multiple tasks and work independentlyMust be able to develop and maintain professional, service-oriented working must be able to understand and comply with policies and procedures.
Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some postsecondary education preferredAdditional training or working knowledge of related business.
Two to five years experience working in hospital access, physician office or billing and collections or an equivalent combination of relevant education and /or 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.
Duke aspires to create a community built on collaboration, innovation, creativity, and belongingOur collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishesTo 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 heardAll 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 abilitiesAdditional information and provision for requests for reasonable accommodation will be provided by each hiring department.