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CUSTOMER SERVICE ASSOCIATE-FINANCIAL SERVICES

Employer
Duke University
Location
Durham

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Administrative Jobs
Institutional & Business Affairs, Business & Financial Management
Employment Type
Full Time
Institution Type
Four-Year Institution
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Job Details

Auto req ID
112638BR
Duke Entity
PRMO
Job Code
4568 CUSTOMER SERVICE ASSOCIATE
Job Description
Occupational Summary
  • Accurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to pre-admission, admission, pre-registration, registration and customer service functions.
  • Ensure all insurance requirements are me me met prior to patients' arrival and inform patients of their financial liability prior to arrival for services.
  • Arrange payment options with patients and screen patients for government funding sources.
    • Work Performed
  • The Central Financial Service (CFS) Team is responsible for the pre-service financial clearance of international patients, patients with non-contracted plans, and new self-pay and Medicaid patients for the PDC and all hospitals within Duke University Health System.
  • CFS is also responsible for  working claim edits, analyzing and answering billing questions, facilitating review board calls and tr training our CFS processes to other areas at Duke.
  • International Patient Work with the International Patient Services office to financially clear international patients prior to scheduling appointments. 
  • Monitor the patient work queue to ensure all patients registered as international patients are contacted prior to service.
  • Request verification of benefits from the international patient office and send letters of agreements to the international self-pay patients.
  • Non-Contracted Receive and respond to incoming phone calls from scheduling, and other areas at Duke that schedule, with non-contract insurance holders on the phone.
  • Provide insurance benefit education to patients with non-contracted plans.
  • Analyze insurance coverage and benefits for service to ensure timely reimbursement.
  • Calculate and collect cash payments appropriately for patients with non-contracted plans deciding to come to a Duke facility.
  • Out-of-County Self-Pay/Medicaid Review incoming referrals for new patients seeking appointments with out of county Medicaid or self-pay coverage and residing in a county outside of Durham or Wake.
  • Facilitate financial cl clearance via communication with referring offices, scheduling teams and Duke Providers as  appropriate.
  • Respond to physicians inquires and requests.
  • Facilitate and/or attend weekly clinical re review board meetings to document decisions and communicate with referring providers and re referring offices as appropriate.
  • Infusion Clinic and High Impact Drug review boards
  • Review and work new referrals for clinic.
  • Infusion center and high impact drugs for the weekly review boards.
  • Facilitate and/or attend weekly clinical review board meetings to document decisions and communicate with clinical areas as appropriate.
  • Work closely with clinic and Pre-Service Verification teams to ensure proper pre Service
  • Verification teams to ensure proper pre Service Verification teams to ensure proper pre Service Verification teams to ensure proper pre-authorization, clinical notes and required detail is obtained.
  •  Gather necessary documentation to support proper handling of inquiries and complaints.
  • Explain bills according to PRMO credit and collection policies. Examine insurance policies and other third party sponsorship materials for sources of payment.
  • Reconcile daily cash deposit when cash is collected.
    • Knowledge, Skills and Abilities
  • Excellent communication skills, oral and written. 
  • Attentive to the needs of internal and external customers. 
  • Ability to analyze data, perform multiple tasks and work independently. 
  • Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers and supervisors. 
  • Must be able to understand and comply with policies and procedures.
    • QUALIFICATIONS Experience, Education and Licensure
  • A minimum of two years of customer service experience is required.
  • A healthcare background working in medical billing, collections, insurance claims processing, coding, registration or working in a physician’s office is required.
  • Inbound to outbound call center experience preferred.
  • Working  knowledge of the Epic systems preferred.
  • Equivalent combination of relevant education and  experience considered.
  • No licensure required.

    • Location
    Durham
    Requisition Number
    401587542
    Position Title
    CUSTOMER SERVICE ASSOCIATE-FINANCIAL SERVICES
    Shift
    First/Day
    Job Family Level
    C2
    Full Time / Part Time
    FULL TIME
    Regular / Temporary
    Regular
    Department Name
    FINANCIAL SERVICES
    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

    Work requires knowledge of basic grammar and mathematical principles normally required through a high school education. Two-year college degree preferred.Experience

    A minimum of three years direct customer service or call center operations experience is required. A healthcare background working in medical billing, collections, insurance claims processing, coding, registration, working in a medical organization, or like experience in the fields of education, training, training development, is highly preferred. Inbound to outbound call center experience preferred. Working knowledge of Maestro Care system preferred.Degrees, Licensures, Certifications

    N/A

    Organization

    Read our Diversity Profile History

    Duke University was created in 1924 by James Buchanan Duke as a memorial to his father, Washington Duke. The Dukes, a Durham family that built a worldwide financial empire in the manufacture of tobacco products and developed electricity production in the Carolinas, long had been interested in Trinity College. Trinity traced its roots to 1838 in nearby Randolph County when local Methodist and Quaker communities opened Union Institute. The school, then named Trinity College, moved to Durham in 1892, where Benjamin Newton Duke served as a primary benefactor and link with the Duke family until his death in 1929. In December 1924, the provisions of indenture by Benjamin’s brother, James B. Duke, created the family philanthropic foundation, The Duke Endowment, which provided for the expansion of Trinity College into Duke University.Duke Campus

    As a result of the Duke gift, Trinity underwent both physical and academic expansion. The original Durham campus became known as East Campus when it was rebuilt in stately Georgian architecture. West Campus, Gothic in style and dominated by the soaring 210-foot tower of Duke Chapel, opened in 1930. East Campus served as home of the Woman's College of Duke University until 1972, when the men's and women's undergraduate colleges merged. Both men and women undergraduates now enroll in either the Trinity College of Arts & Sciences or the Pratt School of Engineering. In 1995, East Campus became the home for all first-year students.

    Duke maintains a historic affiliation with the United Methodist Church.

    Home of the Blue Devils, Duke University has about 13,000 undergraduate and graduate students and a world-class faculty helping to expand the frontiers of knowledge. The university has a strong commitment to applying knowledge in service to society, both near its North Carolina campus and around the world.

    Mission Statement

    Duke Science"James B. Duke's founding Indenture of Duke University directed the members of the University to 'provide real leadership in the educational world' by choosing individuals of 'outstanding character, ability, and vision' to serve as its officers, trustees and faculty; by carefully selecting students of 'character, determination and application;' and by pursuing those areas of teaching and scholarship that would 'most help to develop our resources, increase our wisdom, and promote human happiness.'

    “To these ends, the mission of Duke University is to provide a superior liberal education to undergraduate students, attending not only to their intellectual growth but also to their development as adults committed to high ethical standards and full participation as leaders in their communities; to prepare future members of the learned professions for lives of skilled and ethical service by providing excellent graduate and professional education; to advance the frontiers of knowledge and contribute boldly to the international community of scholarship; to promote an intellectual environment built on a commitment to free and open inquiry; to help those who suffer, cure disease, and promote health, through sophisticated medical research and thoughtful patient care; to provide wide ranging educational opportunities, on and beyond our campuses, for traditional students, active professionals and life-long learners using the power of information technologies; and to promote a deep appreciation for the range of human difference and potential, a sense of the obligations and rewards of citizenship, and a commitment to learning, freedom and truth.Duke Meeting

     “By pursuing these objectives with vision and integrity, Duke University seeks to engage the mind, elevate the spirit, and stimulate the best effort of all who are associated with the University; to contribute in diverse ways to the local community, the state, the nation and the world; and to attain and maintain a place of real leadership in all that we do.”

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