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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.
General Description of the Job Class
Independently performs specialized or advanced health information activities necessary to organize, maintain, and use electronic patient health records. Activities required include research, analysis and compilation of findings into summarized reports that will be shared within and externally with the Health Information Management Department. Positions at this level have high customer service, strong analytic and problem-solving skills, require interpretation and explanation of policy and external requirements related to privacy, confidentiality of information, positive patient identity, and other department- or organization-wide functions.
Specific job responsibilities are based on the service unit within Health Information Management assigned. Expert computer skills are needed to navigate multiple electronic record systems.
Release of Information: Regular interaction is required with patients, attorneys, governmental agencies, providers of health care, insurance companies, auditing agencies, and researchers. Detailed working knowledge and ability to apply HIPAA regulations, North Carolina General Statutes, and other state and federal laws regarding patient privacy.
Duties and Responsibilities of this Level
Release of Information Functions:
- Review requests for medical records to identify dates of service, entity, provider and ,speif specificic documents requested. Works extensively in the electronic health record and de-centralized electronic databases to locate specific clinical documents for the purpose of fulfilling a request.
- Review patient authorizations to validate HIPAA-required elements and validate the legal authority of the requestor. Reviews out-of-state subpoenas and court orders to determine if they are valid and return to the requestor if they are deemed invalid.
- Coordinates visits from Health Plan Reviewers and Research Monitors through the provision of electronic medical records, the assignment of passwords, and the deactivation of passwords at the conclusion of the visit. Assists the reviewer in locating specific documents as needed.
- Review requests for patient amendments, locate disputed documents in the electronic health record, and notify the provider of the patient's request for amendment. Tracks amendment request to ensure patient is notified of outcome within HIPAA required timeframe.
- Obtains itemized statements from PRMO Self Pay and uses them to calculate lien balances, generate attorney lien letters, and forward itemized statements to the requestor as needed.
- Obtains provider approval to release psychiatric encounter records when requested by the patient and seeks provider approval to release records for minor patients ages 12–17 to parents to comply with additional privacy protections under NC Statute and Federal Law.
- Accompanied copies or original health records to court and the location of scheduled depositions when required. Testifies in court and depositions as to the authenticity of health records containing PHI.
This is a hybrid position requiring both remote and onsite tasks.
Minimum Qualifications
Education
High School Diploma required; preferred Associate's degree in a Health Information Management or related field
Experience
Four years of experience in a health care-related field required, two of which must be in Health Information Management. Candidates with an Associate's degree in HIM require two years of Health Care experience and one year of HIM-specific experience Candidates with a Bachelor's degree in HIM require two years of Health Care experience Candidates with a Bachelor's degree in Health Care require two years of HIM-specific experience
Degrees, licenses, and certifications
preferred: RHIT/RHIA/CHPS/CHDA
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.
Explore Patient Revenue Management Organization
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Duke Health is consistently recognized as a top employer for our dedication to the team members and the patients we serve.
On Forbes list of Best Large Employers, we are the #1 healthcare recipient in North Carolina for 2023.
Our hospitals are consistently recognized as LGBTQ Healthcare Equality Leaders by Healthcare Equality Index.
We are among about 9 percent of U.S. hospitals that hold the American Nurses Credentialing Center’s Magnet Recognition honor.
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We are proud to be named as the #1 healthcare system in North Carolina on Fortune’s America’s Most Innovative Companies 2023 list.
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