customer service associate

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.

Occ Summary Answer and respond to all PRMO-related customer iss uesthat arereceived by way of telephoneand/or writing, meeting customer and departmental goals and objectives. Work Performed Answer and resolv eallinbound inquiries and issues regarding patientaccount statements, ba ddebtwrite off's, explanation of benefits, balance due, and other patien tand insurance billing relatedscenarios.Analyze the patient's problem or issue that is presented by collectinginformation and data andconductingt horough research of the IDX patient accounting systems,Hyland Onbase for documentsthat may have been imaged (EOB's, statements, admitting documen tation,patient correspondence,etc.), Passport or BlueE for eligibility,r esearching payor websitesand/or contacting the payor isneeded. Analyze information for an appropriate solution and take thenecessary action nee ded toresolve the issue. Follow through on all customer issues promptly and accurately untilcompletion. Open work itemsinclude issues that are tracked via PCS workfiles, the customer servicefollow up database andpap erworkfiles.Thoroughly update and document PCS notes or system commentfi elds withall information pertainingtoan inquiry (i.e. questions, answers , actions, follow up itemsrequired).Communicate with the patient, physi cians, collection agency, internaldepartments and all other internaland external customers in a professional, courteous, and respectfulmanner. P ost customer service adjustments when supported by policy, contractualad justments and otheradjustments as deemed necessary following appropriate write offguidelines. Update insurance information and file and/orappeal claims withinsurance companies according todepartment guidelines. Take appropriate actions to bill insurancecompanies or patients with correcte dinformation including accepting and inputting secondary insuranceinform ation into the system andfiling claims. Coordinate patient refund reques ts with the credit balance department.Research EOB's and paymentdetail t o determine if a patient refund is necessary or determine thenatureofs, and attorneysregarding charges for health careservices. Validate thatthe credit balance. Provide financial counseling to patients, guarantorchar ges are correct and request medical reviewand audit when necessary.Discu ss and establish payment plans for patients that require extendedterms t o pay off a balance. Produce itemized statements and mail to patients wh en requested. Assist patients that are requesting charity care byconduct inganinitial screening and sending thatpatient a copy of the charity ca re application when requested. Providefeedback regarding statusofthe app lication when requested from a patient. Obtain and post creditcard payme nts for accounts including authorizedsettlements withindepartmental guid elines. Follow department policy necessary for chargecorrections, trans ferringcredits, coding changes, service and charge disputes,and locatepa yments. Following appropriate policy, update all system information toac cessible fields to include correctregistration information,address, tele phone numbers, guarantorinformation, employer information,insurance info rmation, etc. Identify trends in system problems, trainingor procedural concerns.Make recommendations andprovide feedback regarding corrective a nd preventive action to thesupervisor or manager. Track theproblem to e nsure the inquiry is completed through PSC work files orthe follow up da tabase. Adhere to all HIPAA and confidentiality guidelines. Workwith a d iverse group of internal and external customers (i.e.attorneys,insurance companies,state agencies, physician offices, collectionagencies, etc). Work as a team member towards common goals. Prepare and/or assist with s pecial reports as requested by management. Adhere to ascheduleto ensure customer availability and demonstrateflexibilitytoschedulesaccording to call volume or staffing needs. Perform other related duties incidental t o the work described herein. Knowledge, Skills andAbilities Analytical a nd problem-solving skills Strong organizational skills with the ability to multi-task and followthrough on outstanding issues Strongcomputer ski lls with knowledge of MS Word, MS Excel and e-mail Excellentinterpersona l skills with the ability to communicateeffectively both orally and in w riting Ability to work well with others - strong teamwork skills Must be flexible and able to function in a work environment whereworkand schedu les may change tomeet the needs of the patientDemonstratedability to wor k wellwith customers and deliver excellentcustomer service Ability to c ontrol and manage a phone callBi-lingual preferred Knowledge of DUHS bil ling preferred

Minimum Qualifications
Duke is an Equal OpportunityEmployer committed to provi dingemployment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, geneticinformati on, national origin, race, religion, sex (including pregnancyand pregnan cy related conditions), sexual orientation or militarystatus.

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Duke aspires to create a community built on collaboration,inno vation, creativity, and belonging. Our collective success depends onthe robust exchange of ideas—an exchange that isbest when the richdiversity of our perspectives, backgrounds, and experiences flourishes.To achieve this exchange, it is essential that all members of thecommunity feel se cure and welcome, that the contributions of allindividuals are respected , and that all voices are heard. All members ofour community have a resp onsibility to uphold these values.

Essential Physical Job Functions: Certain jobs at Duke University andDuke University Healt h System may include essential job functions thatrequire specific physic al and/or mental abilities. Additionalinformation and provision for requ ests for reasonable accommodation willbe provided by each hiring departm ent.

Education

Work requires knowle dge of basic grammar and mathematical principlesnormally required throug h a high school education. Two-year collegedegree preferred.

Experience
A minimum of three years direct customer service or c all centeroperations experience is required. A healthcare background w orking inmedical billing, collections, insurance claims processing, codi ng,registration, working in a medical organization, or like experience i nthe fields of education, training, training development, is highlyprefe rred.Inbound to outbound call center experience preferred.Working knowle dge of Maestro Care system preferred.

Degrees, Licensures, Certif ications

N/A

Duke is an 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 (including pregnancy and pregnancy related conditions), sexual orientation or military status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends onthe 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 essential job 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.