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CUSTOMER SERVICE ASSOCIATE - INCOMING CALL CENTER & CORRESPONDENCE

Employer
Duke University
Location
INCOMING CALL CENTER & CORRESPONDENCE

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Employment Type
Full Time
Institution Type
Four-Year Institution
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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 Primary Care. 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. Occ Summary

Answer and respond to all PRMO-related customer i ssues that are receivedby way of telephone, in person and/or writing, me eting customer anddepartmental goals and objectives.


Work Pe rformed

Answer and resolve all inbound inquiries and issues regar ding patientaccount statements, bad debt write off's, explanation of ben efits,balance due, and other patient and insurance billing related scena rios.Analyze the patient's problem or issue that is presented by collect inginformation and data and conducting thorough research of the IDX pati entaccounting systems, Hyland Onbase for documents that may have beenima ged (EOBs, statements, admitting documentation, patientcorrespondence, e tc.), Passport or BlueE for eligibility, researchingpayor websites and/o r contacting the payor is needed. Analyzeinformation for an appropriate solution and take the necessary actionneeded to resolve the issue.Follow through on all customer issues promptly and accurately untilcompletion. Open work items include issues that are tracked via PCSworkfiles, the c ustomer service follow up databaseand paper workfiles.Thoroughly update and document PCS notes or system comment fields withall information per taining to an inquiry (i.e. questions, answers,actions, follow up items required).Communicate with the patient, physicians, collection agency, i nternaldepartments and all other internal and external customers in apro fessional, courteous, and respectful manner.Post customer service adjust ments when supported by policy, contractualadjustments and other adjustm ents as deemed necessary followingappropriate write off guidelines.Updat e insurance information and file and/or appeal claims withinsurance comp anies according to department guidelines. Take appropriateactions to bil l insurance companies or patients with correctedinformation including ac cepting and inputting secondary insuranceinformation into the system and filing claims.Coordinate patient refund requests with the credit balanc edepartment.Research EOB?s and payment detail to determine if a patient refund isnecessary or determine the nature of the credit balance.Provid e financial counseling to patients, guarantors, and attorneysregarding c harges for health care services. Validate that charges arecorrect and re quest medical review and audit when necessary.Discuss and establish paym ent plans for patients that require extendedterms to pay off a balance.P roduce itemized statements. Mail and provide itemized statements topatie nts when requested.Assist patients that are requesting charity care by c onducting aninitial screening and sending or providing that patient a co py of thecharity care application when requested. Provide feedback regar dingstatus of the application when requested from a patient.Obtain and p ost credit card payments for accounts including authorizedsettlements wi thindepartmentalguidelines. Follow department policynecessary for char ge corrections, transferring credits, coding changes,service and charge disputes, and locate payments.Following appropriate policy, update all s ystem information toaccessible 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 feedba ck regarding corrective andpreventive action to the supervisor or manage r. Track the problem toensure the inquiry is completed through PSC work files or the follow updatabase.Adhere to all HIPAA and confidentiality g uidelines.Work with a diverse group of internal and external customers ( i.e.attorneys, insurance companies, state agencies, physician offices,co llection agencies, etc).Work as a team member towards common goals.Prepa re and /or assist with special reports as requested by management.Adhere to a schedule to ensure customer availability and demonstrateflexibilit y to schedules according to patient or call volume or staffingneeds.Perf orm other related duties incidental to the work described herein.


Knowledge, Skills and Abilities

Analytical and problem-solv ing skillsStrong organizational skills with the ability to multi-task an d followthrough on outstanding issuesStrong computer skills with knowled ge of MS Word, MS Excel and e-mailExcellent interpersonal skills with th e ability to communicateeffectively both orally and in writingAbility to work well with others - strong teamwork skillsMust be flexible and able to function in a work environment where workand schedules may change to meet the needs of the patientDemonstrated ability to work well with cus tomers and deliver excellentcustomer serviceAbility to control and manag e a phone callBi-lingual preferredKnowledge of DUHS billing preferred</p >

Minimum Qualifications


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 preferred. 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 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.

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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