Durham, North Carolina

 

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.

 

The Revenue Manager will oversee the revenue cycle activities associated with services of the Pharmacy Service Line, with the goal of maximizing reimbursement in a cost-effective manner that is in compliance with federal/state and payer-specific billing requirements.

 

Work Performed

Coordinate activities of staff responsible for charge capture, coding, charge entry, insurance follow up, reimbursement analysis, or other PRMO function for assigned clinical area Monitor performance for staff responsible for appointment scheduling, registration, clinic check-in, and clinic collections. Develop and prepare/utilize reports to track financial and operational performance across the entire spectrum of the revenue cycle for assigned clinical area. Review and recommend changes/updates to the departments charge master(s) to maintain fees at levels that maximize reimbursement. Review and recommend changes to department's charge capture documents to facilitate accurate and comprehensive billing in compliance with annualCPT-4 and ICD-9 updates. Identify revenue cycle problems, research/analyze data to resolve issues, identify and select alternatives to address outstanding issues, and implement solution s for improvement. Work with financial analyst, physicians, and administrative leadership to educate and train providers and staff about coding and other outstanding revenue cycle issues. Act as a liaison to management and staff in the designated clinical area, PDC, PRMO, DUHS Hospitals, and third-party payers on revenue cycle activities for assigned areas. Continuously research, monitor, provide education and implement payer regulations and guidelines related to revenue management activities of the assigned clinical area. Coordinate revenue management orientation and educational activities of clinical personnel including providers and staff about coding and other outstanding revenue cycle issues. Develop and utilize management models to monitor productivity and quality of staff performance. Develop and manage the budget for the staff and activities that are directly managed. Train, direct, and coordinate activities of assigned financial analyst/or other employees. Perform other related duties incidental to the work described herein.

 

Knowledge, Skills and Abilities

Experience in these areas is preferred: CPT/ICD/9 Coding, reimbursement s stems including IDX, TES, Medicode, PAS, financial analytical skills, spreadsheet, database, APC, DRG, and third party reimbursement guidelines and procedures.

 

Minimum Qualifications

 

Education
Bachelors degree required. Masters degree preferred.

 

Experience
Six years of experience in the healthcare industry is required. Pharmacy and Revenue Cycle Background preferred.

 

Degrees, Licensures, Certifications
BA, BBA, RN, CPC, RRA, or CPA, or higher

 

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.

 

Durham, North Carolina

As a world-class academic and health care system, Duke Health strives to transform medicine and health locally and globally through innovative scientific research, rapid translation of breakthrough discoveries, educating future clinical and scientific leaders, advocating and practicing evidence-based medicine to improve community health, and leading efforts to eliminate health inequalities.

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