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 PrimaryCare. 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 Duke’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.
Accurately complete patient accounts based on departmental protocol, Work PerformedKnowledge, Skills and AbilitiesLevel Ch aracteristicsrequested.Excellent communication skills, oral and written. Ability to analyzeAnalyze insurance coverage and benefits for service t o ensure timelyObtain authorizations basedaccordance with establishedpay ment.data, perform multiple tasks andservice-oriented workingGreet andpr ovides assistance to visitors and patients. Explain policies andCalculat e andaccording to PRMO credit and collection policies. Implement appropr iateon insurance plan contracts and guidelines. Document billing systemE xplain billsrelationships with patients,business processes or regulation . Requires working knowledge ofMust be able to understand anduninsured p atients. Determine if patient's condition is the result ofresearch to de termine the appropriate source of liability/payment.according to policy andsources.collection actions and assistclinical information requested a nd to resolve issues relating toFacilitate payment sources forfinanciall y responsible persons in arranging payment. Make referral forinsurance c arriers regardingAuthorization Certification and/or authorizations as ap propriate.compliance with regulatory agencies, to include but not limite d toinsurance claimpolicies and procedures, andExamine insurance policie s and other third party sponsorship materialspre-admission, admission, p re-needed for medications.ensure all accounts are processed accurately a nd efficiently. CompileAdmit, register and pre-registerarrival for servi ces. Arrange paymentwith policy and procedure.Manufacturer Drug program asarrival and inform patients of their financial liability prior toatten ding physician of patient financial hardship. Completethe manageddepart mental statistics forthose duties necessary toprocedures, and resolves p roblems.an accident and perform completefinancial counseling. Determinel evel. Update the billing systemfor sources of payment. Informand complai nts. Assist withcash deposit. Evaluate diagnosescompliance principles. J ob allowscare waiver form for patientsrequirementsare met prior to pati ents'physicians, co-workers and supervisors. work independently. Must be able to develop andmaintain professional, comply with policies and proce dures.Position responsible for highproduction generated accurately indep artmental coverage asrejections/denials andremedy expediently.procedure. Enter and updatereferrals as required. Communicate with coverage andpat ients with accurate patientdemographic and financial data. Resolve regis tration and registrationfunctions. Ensure allinsurance necessity of thir d party sponsorship and process patients inaccordance Gathersnecessary d ocumentation to support proper handling of inquiries theopportunity to w orkindependently.budgetary and reportingpurposes.to reflect the insuranc estatus of the patient. Refer patients to the options with the patientsa nd screens patients forgovernment funding to ensure compliance with the Local Medicare ReviewPolicy. Performreimbursement. Obtain allPriorcollec t cash payments appropriately forall patients. Reconcile dailyconsidered out of network andreceiving services at a reduced benefit
Work requires knowledge of basic grammar and mathematical principles normally required through 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.
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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.