What are the responsibilities and job description for the Revenue Cycle Specialist - Operational Staffing Pool - Hybrid position at Duke?
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.
HYBRID POSITION: Monday - Friday (First Shift)
Required Qualifications at this Level Duties and Responsibilities of this Level:
Perform various complex functions related to the revenue cycle operations. This will include all ancillary departments of the PRMO and will involve refining existing processes related to revenue cycle activities and supporting overall revenue cycle goals. This job is reserved for the PRMO Operational Staffing (Float) Pool. This position will report to the manager of the Operational Staffing Pool.
10% Under general supervision, the Revenue Cycle Specialist provides patient revenue management support through all the different areas of the revenue cycle, to include but not limited to Incoming Call Center, Billing and Collections, Cash Management and Payment Posting, Scheduling, Pre-Registration and Charge Capture, Self-Pay Collections, Credit Balance, Authorization Denials, Provider Enrollment, Support Services, and Revenue Management and Coding.
Level I: 70% Assignments are transactional and productivity based. Specific job duties may include one or more of the following responsibilities in various areas of the revenue cycle: answer and resolve inbound inquiries and issues regarding patient account statements, explanation of benefits, balance due, and other patient and insurance inquiries, scheduling inpatient and outpatient appointments, pre-registration of patients prior to service, billing # sending out claims and patient statements for reimbursement, cash management and payment posting, analyze insurance coverage and benefits for service to ensure timely reimbursement, cash collections, attorney requests, refund letters, undistributed money, claim edits, paper claims, charge correction, credit balance review and processing.
Level II: 20% In addition to the responsibilities of Level I, Level II assignments also include one or more of the following, but not limited to: financial and trend analysis work in areas such as self-pay and account receivable; denials review, appeals, and resolution; support services schedule template editing and building; reconciliations of cash accounts and resolve outstanding balances; provider enrollment; support in Revenue Management & Coding; Patient Account Analyst roles for various departments, and special projects that require analysis and feedback, which may include reallocation of revenue. The Revenue Cycle Specialist will provide coverage and serve as a temporary resource in various areas of the revenue cycle. Specific assignments will be managed by PRMO Operational Staffing Pool office. The Revenue Cycle Specialist will initiate and develop relationships with customers in order to gather and process information or resolve issues in order to receive accurate reimbursement and optimize internal and external customer satisfaction.
Education: High school diploma is required with additional training or working knowledge of related business. Completion of an associate’s degree program in accounting or business related field is preferred.
Experience: Three years of experience in healthcare revenue cycle operations or support is required with a minimum of one year working in medical billing, collections, insurance claims processing, coding, registration or working in a physician’s office. Working knowledge of Maestro Care is preferred. OR EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND EXPERIENCE.
Degrees, Licensure, and/or Certification: N/A
Knowledge, Skills, and Abilities: Excellent communication skills, oral and written. Ability to analyze data, perform multiple tasks and work independently. Must be able to develop and maintain professional, service- oriented working relationships with patients, physicians, co-workers and supervisors. Must be able to understand and comply with policies and procedures. Ability to work well with others - strong teamwork skills, strong patient skills. Must be flexible and able to function in a work environment accounting systems knowledge and where work and schedules may change to meet the needs of the customer.
Minimum Qualifications
Education
Work requires knowledge of basic grammar and mathematical principles normally required through a high school education. Completion of a bachelor’s degree program in accounting or business related field preferred.
Experience
A minimum of five years’ experience in healthcare revenue cycle operations or support is required. Working knowledge of the IDX, Siemens Invision and Meditech patient account systems preferred. OR EQUIVALENT COMBINATION OF RELEVANT EDUCATION AND EXPERIENCE
Degrees, Licensures, Certifications
N/A
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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.
