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.
Work Schedule (Friday, Saturday, & Sunday) 7:00 AM-7:30 PM
Occ Summary Work Performed
Ability to analyze insurance coverage and benefits for service to ensure timely obtain authorizations based on payment relationships with patients, physicians, co-workers, and supervisors. The position is responsible for high production generated accurately and complete patient accounts based on departmental protocol, and data, performing multiple tasks and being service-oriented. Greet and provide assistance to visitors and patients. Explain policies and calculate and according to PRMO credit and collection policies. Implement appropriate work independently. Must be able to develop and maintain professionalism, and comply with policies and procedures on insurance plan contracts and guidelines. Document billing system explains and bills. Must be able to understand uninsured patients. Determine if the patient's condition is the result of research to determine the appropriate source of liability/payment according to policy and departmental coverage as requested coverage and collection actions and assist clinical information requested and resolve issues relating to rejections/denials and remedy expediently. Facilitate payment sources for financially responsible persons in arranging payment. Make referrals for insurance carriers regarding authorization Certification and/or authorizations as appropriate procedures. Enter and update referrals as required.
Communicate with compliance with regulatory agencies, including but not limited to insurance claim policies and procedures, and examine insurance policies and other third-party sponsorship materials-admission, admission, and pre-needed medications. Collect cash payments appropriately for all patients. Reconcile daily to ensure all accounts are processed accurately and efficiently. Compile Admit, register, and pre-register arrival for services. Arrange payment for patients with accurate patient demographic and financial data. Resolve with policy and procedure. Manufacturer Drug program as registration and registration functions. Ensure all insurance arrival and inform patients of their financial liability prior to attending physician of patient financial hardship. Gathers necessary documentation to support proper handling of inquiries departmental statistics for the necessity of third-party sponsorship and process patients in accordance. Refer patients to the budgetary and reporting purposes procedures, and resolves problems. reimbursement. Obtain all Prior an accident and perform completely to ensure compliance with the Local Medicare Review Policy. Perform financial counseling. Update the billing system for sources of payment. Assist with cash deposits. Evaluate diagnoses care waiver form for patients requirements are met prior to patients options with the patients and screens patients for government funding sources considered out of network and receiving services at reduced benefit accordance with established business principles. The job allows the processes or regulation. Requires working knowledge of compliance opportunity to work independently. The position is for the third shift every other weekend and prn as needed.
Friday - Sunday; 7:00 AM - 7:30 PM
Work requires knowledge of basic grammar and mathematical principles normally requiredthrough a high school education, with some postsecondary education preferred. Additional training or working knowledge of related business.
Two years experience working in hospital service access, clinical service access, physician office or billing and collections. Or, an Associate's degree in a healthcare related field and one year of experience working with the public. Or, a Bachelor's degree and one year of experience working with the public.
Degrees, Licensures, Certifications
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