Patient Revenue Manager

3 days ago


Durham, North Carolina, United States Duke Health Full time

About Duke Health's Patient Revenue Management Organization

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Duke University Health System - Patient Revenue Management Office (PRMO) is seeking a Financial Care Counselor to join our team. This role is responsible for accurately completing patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies.

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Key responsibilities include:

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  • Ensuring all insurance requirements are met prior to patients' arrival and informing them of their financial liability prior to arrival for services;">
  • Documenting billing system and explaining policies and departmental coverage as requested;">
  • Calculating and applying PRMO credit and collection policies;">
  • Implementing appropriate cash payments for all patients;">
  • Reconciling daily necessity of third party sponsorship and processing patients in accordance with reimbursement;">
  • Obtaining Prior Authorization Certification and/or authorizations as appropriate;">
  • Admitting, registering, and pre-registering patients with accurate patient demographic and financial data;">
  • Resolving insurance claim rejections/denials and remediating expediently;">
  • Evaluating diagnoses to ensure compliance with the Local Medicare Review Policy;">
  • Performing duties necessary to ensure all accounts are processed accurately and efficiently;">
  • Collection actions and assisting financially responsible persons in arranging payment;">
  • Making referrals for financial counseling when necessary;">
  • Determining with policy and procedure;">
  • Examining insurance policies and other third-party sponsorship materials for sources of payment;">
  • Informing attending physicians of patient financial hardship;">
  • Completing managed care waiver forms for patients considered out-of-network and receiving services at a reduced benefit level;">
  • Updating the billing system to reflect the insurance status of the patients;">
  • Gathering necessary documentation to support proper handling of inquiries and complaints;">
  • Assisting with tasks according to policy and procedure;">
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In order to be successful in this role, candidates should have experience working in hospital service access, clinical service access, physician office or billing and collections. Alternatively, an Associate's degree in a healthcare-related field and one year of experience working with the public may also be considered. A Bachelor's degree and one year of experience working with the public is another acceptable combination of skills and qualifications.

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The estimated salary for this position is around $55,000-$65,000 per year, depending on location and experience. Duke University Health System offers a comprehensive benefits package, including medical, dental, and vision insurance, retirement savings plan, paid time off, and more.

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We are committed to creating a community where diversity is valued and everyone feels welcome and respected. All members of our community have a responsibility to uphold these values and contribute to an exchange of ideas that enriches our work and fosters growth.



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