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CUSTOMER SERVICE ASSOCIATE

Employer
Duke University
Location
INCOMING CALL CENTER & CORRESPONDENCE
Closing date
Jul 28, 2021
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Job Details

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.

CUSTOMER SERVICE ASSOCIATE

Occ Summary

Answer and respond to all PRMO-related customer issues that are received by way of telephone, in person and/or writing, meeting customer and departmental goals and objectives.

Work Performed

  • Answer and resolve all inbound inquiries and issues regarding patient account statements, bad debt write off's,
  • Explanation of benefits, balance due, and other patient and insurance billing related scenarios.
  • Analyze the patient's problem or issue that is presented by collecting information and data and conducting thorough research of the IDX patient accounting systems, Hyland Onbase for documents that may have been imaged (EOBs, statements, admitting documentation, patient correspondence, etc.), Passport or Blue E for eligibility, researching payor websites and/or contacting the payor is needed.
  • Analyze information for an appropriate solution and take the necessary action needed to resolve the issue.
  • Follow through on all customer issues promptly and accurately until completion.
  • Open work items include issues that are tracked via PCSworkfiles, the customer service follow up database and paper workfiles.
  • Thoroughly update and document PCS notes or system comment fields with all information per training to an inquiry (i.e. questions, answers, actions, follow up items required).
  • Communicate with the patient, physicians, collection agency, internal departments and all other internal and external customers in a professional, courteous, and respectful manner.
  • Post customer service adjustments when supported by policy, contractual adjustments and other adjustments as deemed necessary following appropriate write off guidelines.
  • Update insurance information and file and/or appeal claims with insurance companies according to department guidelines.
  • Take appropriate actions to bill insurance companies or patients with corrected information including accepting and inputting secondary insurance information into the system and filing claims.
  • Coordinate patient refund requests with the credit balance department.
  • Research EOB?s and payment detail to determine if a patient refund is necessary or determine the nature of the credit balance.
  • Provide financial counseling to patients, guarantors, and attorneys regarding charges for health care services.
  • Validate that charges are correct and re quest medical review and audit when necessary.
  • Discuss and establish payment plans for patients that require extended terms to pay off a balance.
  • Produce and mail itemized statements.
  • Provide itemized statements to patients when requested.
  • Assist patients that are requesting charity care by conducting an initial screening and sending or providing that patient a copy of the charity care application when requested.
  • Provide feedback regarding status of the application when requested from a patient.
  • Obtain and post credit card payments for accounts including authorized settlements within departmental guidelines.
  • Follow department policy necessary for charge corrections, transferring credits, coding changes, service and charge disputes, and locate payments.
  • Following appropriate policy, update all system information to accessible fields to include correct registration in formation, address, telephone numbers, guarantor information, employer in formation, insurance information, etc.
  • Identify trends in system problems, training or procedural concerns.
  • Make recommendations and provide feedback regarding corrective and preventive action to the supervisor or manager.
  • Track the problem to ensure the inquiry is completed through PSC work files or the follow up database.
  • Adhere to all HIPAA and confidentiality guidelines.
  • Work with a diverse group of internal and external customers (i.e. attorneys, insurance companies, state agencies, physician offices, collection agencies, etc).
  • Work as a team member towards common goals. Prepare and /or assist with special reports as requested by management.
  • Adhere to a schedule to ensure customer availability and demonstrate flexibility to schedules according to patient or call volume or staffing needs.
  • Perform other related duties incidental to the work described herein.

Knowledge, Skills and Abilities

  • Analytical and problem-solving skills
  • Strong organizational skills with the ability to multi-task and follow through on outstanding issues
  • Strong computer skills with knowledge of MS Word, MS Excel and e-mail.
  • Excellent interpersonal skills with the ability to communicate effectively both orally and in writing.
  • Ability to work well with others - strong teamwork skills
  • Must be flexible and able to function in a work environment where work and schedules may change to meet the needs of the patient.
  • Demonstrated ability to work well with customers and deliver excellent customer service
  • Ability to control and manage a phone call
  • Bi-lingual preferred
  • Knowledge of DUHS billing preferred

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

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.

Company

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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