CUSTOMER SERVICE ASSOCIATE - OMING CALL CENTER & MY CHART

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

About Duke Health's Patient Revenue Management Organization

Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.

Occ Summary

Answer and respond to all PRMO-related c ustomer issues that are receivedby way of telephone, in person and/or wr iting,meeting customer anddepartmental goals and objectives.

WorkPerformed

Answer and resolve all inbound inquiriesand issues regarding patientaccount statements, bad debt write off's, explanation ofbenefits,balance due, and other patient and insurance billing related scenarios.Analyze the patient's problem or issue that is presented by co llectinginformation and data and conducting thorough research of the IDX patientaccounting systems, Hyland Onbase for documents that may have be enimaged (EOBs, statements, admitting documentation, patientcorresponden ce,etc.), Passport or BlueE for eligibility, researchingpayor websites a nd/or contacting the payor is needed. Analyzeinformation for an appropri atesolution and take the necessary actionneeded to resolve the issue.Fol lowthrough on all customer issues promptly and accurately untilcompletio n.Open work items include issues that are tracked via PCSworkfiles, the customer service follow up database andpaper workfiles.Thoroughly update and document PCS notes or system comment fields withall information pert aining to an inquiry (i.e. questions,answers,actions, follow up itemsre quired).Communicate with the patient, physicians, collection agency, int ernaldepartments and all other internal and external customers in aprofe ssional, courteous, and respectful manner.Post customer service adjustme nts when supported by policy, contractualadjustments and other adjustmen tsas deemed necessary followingappropriate write off guidelines.Update i nsurance information and file and/or appeal claims withinsurance compani es according to department guidelines. Take appropriateactions to bill i nsurance companies or patients with correctedinformation including accep ting and inputting secondary insuranceinformation into the system andfil ing claims.Coordinate patient refundrequests with thecredit balance department.Research EOB?s and payment detail to determine if a patientrefuan cial counseling to patients, guarantors, and attorneysregarding chargend isnecessary or determine the nature of the credit balance.Provide fins f or health care services. Validate that charges arecorrect and requestmed ical review and audit when necessary.Discuss and establish payment plans for patients that require extendedterms to pay off a balance.Produce ite mized statements. Mail and provide itemized statements topatients whenre quested.Assist patients that are requesting charity care by conductingan initial screening and sending or providing that patient a copy ofthechar ity care application when requested. Provide feedback regardingstatusof the application when requested froma patient.Obtain and post creditcard payments for accounts including authorizedsettlements withindepartmenta l guidelines. Follow department policynecessary for charge corrections, transferring credits, coding changes,service and chargedisputes, and loc ate payments.Following appropriate policy, update all systeminformation toaccessible fields to include correct registration information, address ,telephone numbers, guarantor information, employer information,insuranc e information, etc.Identify trends insystem problems,training or proced ural concerns.Make recommendations and provide feedback regarding correc tive andpreventive action to the supervisor or manager. Track the proble m toensure the inquiry is completed through PSC workfiles orthe follow u pdatabase.Adhere to all HIPAA and confidentiality guidelines.Work with a diverse group of internal and external customers (i.e.attorneys, insura nce companies, state agencies, physician offices,collectionagencies, etc ).Work as ateam member towards commongoals.Prepare and /or assistwith s pecial reports as requested by management.Adhereto a schedule to ensure customer availability and demonstrateflexibility to schedules according to patient or call volume or staffingneeds.Perform otherrelated duties i ncidental to the work described herein.

Knowledge, Skills an d Abilities

Analytical and problem-solving skillsStrong organizat ional skills with the ability to multi-task and followthrough on outstan ding issuesStrong computer skills withknowledge of MSWord, MS Excel and e-mailExcellent interpersonal skills with the abilityto communicateeffe ctively both orally and in writingAbility towork wellwith others -strong teamwork skillsMust be flexible and ableto function in a work environme nt where workand schedules may change tomeet the needs of the patientDem onstrated ability to work well with customers and deliver excellentcusto mer serviceAbility to control and manage a phone callBi-lingual preferre dKnowledge of DUHS billing preferred

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.

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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.