Duke University Hospital is consistently rated as one of the best in the United States and is known around the world for its outstanding care and groundbreaking research. Duke University Hospital has 1,048 licensed inpatient beds and offers comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center; a major surgery suite containing 65 operating rooms; an endo-surgery center; a separate hospital outpatient surgical department with nine operating rooms and an extensive diagnostic and interventional radiology area. For 2021-2022, U.S. News and World Report ranked Duke University Hospital nationally in 11 adult specialties: cancer, cardiology & heart surgery, diabetes & endocrinology, ear, nose & throat, gastroenterology & GI surgery, gynecology, neurology & neurosurgery, ophthalmology, orthopedics, pulmonology & lung surgery, and urology. Duke University Hospital is also ranked first in North Carolina and first in the Raleigh-Durham area.

In addition to its hospitals, Duke Health has an extensive, geographically dispersed network of outpatient facilities that include primary care offices, urgent care centers, multi-specialty clinics and outpatient surgery centers.

Duke University Hospital Cancer Center is seeking to hire a Patient Service Representative!

Occ Summary

Responsible for accurate and 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-registrationand registration functions. Ensure all insurance requirements are met prior to patients' arrival, and inform patients of their financial liability. Arranges payment options with the patients and screens patients for government funding sources. This is position has high customer service with our payors and physicians by phone and requires excellent customer service skills. This position is very similar to the Financial Care Counselor. This position completes all preliminary work. The Financial Counselor completes the work when the patient arrives.

HOURS:

Full-time 8am - 4:30pm

Work Performed

Analyze insurance coverage and benefits for service to ensure timely Explain billing to patients Obtain authorizations based uninsured patients. Determine if patient's condition is the result of departmental coverage as requested. reimbursement. Obtain all PAC and/or authorizations as appropriate. Facilitate referral to Financial Services for payment sources for an accident, performing complete research to determine the appropriate source of liability/payment. Schedules and pre-register patients, correcting as necessary all patient demographic and financial data. Resolve insurance claim rejections/denials and remedy expediently. Call patients to remind them to bring balances due, co-pays, co insurance and deductible. Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy. Perform those duties necessary to ensure all accounts are processed accurately and efficiently. Promote and maintain excellence in customer service. according to PRMO credit and collection policies, when discussing insurance with patients. Implement appropriate collection actions and assist financially responsible persons in arranging payment. Make referral to Financial Services Representative for counseling. Determine necessity of third party sponsorship and process patients per policy and procedure. Examine insurance policies and other third party sponsorship materials for sources of payment. Inform attending physician of patient financial hardship. Update the billing system to reflect the insurance status of the patient. Provides timely and effective customer service to internal customers. Assist with on insurance plan contracts / guidelines, document in billing system per policy and procedure. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage and payment for specific patients and benefits.

Knowledge, Skills and Abilities

Excellent communication skills, oral and written. Ability to analyze relationships with patients, physicians, co-workers and supervisors. data, perform multiple tasks and work independently. Must be able to develop and maintain professional, service-oriented working Must be able to understand and comply with policies and procedures.

Manager Experience Preferences:

Detailed person with large project experience

Experience ordering medical supplies

Ability to muli-task and handle several competing projects

Level Characteristics

N/A

Minimum Qualifications

Education

Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some postsecondary education preferred. Additional training or working knowledge of related business.

Experience

Two to five years experience working in hospital access, physician office or billing and collections or an equivalent combination of relevant education and /or experience

Degrees, Licensures, Certifications

None required

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.