Job description

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Duke Entity
Job Code
Job Description
Occ Summary
Coordinate, prepare and analyze complex accounts receivable and/or financial reports. Review and analyze trends, advising PRMO, DUHS and PDC leadership regarding conclusions and recommendations. Serve as expert resource for covered area.

Work Performed
Manage appropriate systems for accounts receivable and/or financial reporting.
Prepare written reports and analyses for PRMO, DUHS and PDC leadership highlighting trends and appropriate recommendations/conclusions.Serve as an expert resource to leadership in the decision-making process.
Plays an integral role in implementing and managing and change related to area of expertise.
Maintain liaison with DUHS, PRMO and PDC management and staff,documenting reports and analyses and discussing results, trends and recommendations.
Conduct detailed research to identify trends, including a review of specifics in the appropriate accounts receivable and /or financial systems.
Act as a technical resource to operational management and staff on the appropriate interpretation of accounts receivable and/or financial data.
Coordinate and mentor staff regarding accounts receivable and financial systems, analyses, reports and policies/procedures.Identify process improvements, including staff education/training,operational workflow modifications, system enhancements and external payer policy changes and work with appropriate personnel to implement those improvements.
Organize and lead committee meetings across DUHS,
PRMO and PDC as it relates to accounts receivable and or financial data operation improvements.
May recommend various personnel actions including, but not limited to,hiring, performance appraisals, promotions, transfers and vacation schedules.

Work Performed

Denial Root Cause Analysis - 40%

  • Analyze denial and write-off data to identify common themes and develop overall assumptions;perform account level analysis based on assumption to determine denial and write-off root cause.
  • Develop and distribute clinic/department/user level denial and write-off reporting; track identified issues and actionable recommendations
  • Summarize conclusions and identify improvements resulting in denial reduction (i.e. including staff education/training, operational workflow modifications, system enhancements and external payer policy changes); collaborate with appropriate personnel to implement proposed improvements
  • As required organize and lead meetings related to the reduction of denials

  • Prepare Authorization Denial Reports - 30%
  • Review patient access work queue volumes and contents (e.g. patient work queues,claim edit work queues, charge review work queues) and identify potential process and system failures such as inactivity, growth, inconsistent in/outflow
  • Request action plans from Administrators/Managers responsible for patient access work queues demonstrating inactivity or growth; monitor and track progress of action plan and provide summary on progress to department leadership
  • Review volumes for patient access work queue rules (e.g. patient work queue rules,claim edit work queue rules) and identify missed or inappropriately routed appointments, accounts, or invoices
  • Submit service requests to resolve issues identified with work queues or work queues rules;participate in testing enhancements or fixes for release to the production environment# Review patient access related service requests for work queue rule breaks (e.g.patient work queue rules, claim edit work queue rules) and resolve the ticket
  • Create user notifications

  • Quality Audits - 25%
  • Perform routine quality audits for designated staff/clinics to determine effectiveness of financial counseling functions
  • Provide QA support to clinic managers; deliver periodic education on the QA process to clinic managers
  • Maintain summary level QA results on designated analyst QA reviews and clinic manager QA results
  • Participate in developing staff education materials aimed at improving the quality of insurance verification and authorization

  • General - 5%
  • Participate in work groups and committees focused on improvements in registration and authorization workflows
  • Perform other related duties incidental to the work described herein

  • Knowledge, Skills and Abilities
    Data analysis and reporting
    Ability to work and meet deadlines in a fast-paced, dynamic,project-oriented environment
    Knowledge of Patient Access/Service Access and Pre-Registration/Authorization workflows
    Ability to present data in multiple venues both numerically and graphically
    Ability to relate operational performance in the healthcare environment and to present information to all levels of management
    Epic/Maestro Care experience, especially as it pertains to revenue cycle, reporting, data and root cause analysis
    Insurance Claims
    Microsoft Office (Excel, Access, Word, Powerpoint), including intermediate skills in writing formulas, creating pivot tables, and manipulating data in Microsoft Excel
    Excellent communication skills (verbal and written) are essential
    Requisition Number
    Position Title
    Job Family Level
    Full Time / Part Time
    Regular / Temporary
    Department Name
    Minimum Qualifications
    Duke University 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 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.Education

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

    Four years of experience in healthcare accounts receivable, financial management, accounting or a directly related field is required.




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    Job No:
    Posted: 3/15/2019
    Application Due: 5/14/2019
    Work Type: