Medicaid Eligibility Analyst

1 week ago

Durham, United States Duke University Full time

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 University Health System - Patient Revenue Management Office (PRMO) seeks to hire a Medicaid Eligibility Analyst who will embrace our mission of Advancing Health Together.

This is a hybrid remote position working between 1-4 days a week remotely depending on the needs of the department

Work Hours:

Monday - Friday 8:00am - 5:00pm

General Description of the Job Class

  • Coordinate and facilitate the Medicaid application process across multidisciplinary entities to obtain Medicaid eligibility for patients entitled to Medicaid for the purpose of attaining reimbursement for services provided by Duke University Health System.
  • Compile, analyze and report on the performance of departmental operating units, noting trends and making recommendations or conclusions regarding progress.
  • Analyze and provide feedback for departmental specific reports, i.e. Missing Contractual Report, Available to Post, Medicare/Medicaid Quarterly Reports, Unapplied Cash Reconciliations and Key Performance Indicators (KPI's).
  • Assist management in forecasting by providing historical information.
  • Work with departmental directors, managers and appropriate personnel to ensure budgetary compliance.
  • Ensure departmental goals are satisfied prior to month/year-end closings.
  • Make recommendations to improve financial systems; perform in house audits of operating units; analyze deficiencies and report to manager/director.
  • Assist in developing and defining short and long term departmental specific goals and objectives.
  • Manage and delegate customer service database inquiries.
  • Review and resolve executive inquiries from customer service database.
  • Creation and development of work assignments including training of employees.
  • Recommend various personnel actions including, but not limited to, hiring performance appraisals, promotions, transfers and scheduling.
  • Maintain professional relationship with external agencies and professional organizations concerning fiscal operations, i .e. PDC Finance and Corporate Finance, banks and bank card merchants and healthcare companies, etc.
  • Perform daily balancing and research out of balance situations within DUHS accounts receivable sub-ledger systems and other interfaces and resolve differences.


Minimum Qualifications

Education

Bachelor's degree in business, healthcare administration, accounting, finance or a related field is required.

Experience

Four years of related experience is required.

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 belonging. Our collective success depends on the 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 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.

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