CUSTOMER SERVICE ASSOCIATE - INCOMING 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 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 database and 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 e department.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 thin departmental guidelines. 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

Duke is an Equal Opportunity Employer committed to provi dingemployment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, geneticinformati on, national origin, race, religion, sex (including pregnancyand pregnan cy related conditions), sexual orientation or militarystatus.

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Duke aspires to create a community built on collaboration,inno vation, creativity, and belonging. Our collective success depends onthe robust exchange of ideas—an exchange that is best when the richdiversity of our perspectives, backgrounds, and experiences flourishes.To achieve this exchange, it is essentialthat all members of thecommunity feel se cure and welcome, that the contributions of allindividuals are respected , and that all voices are heard. All members ofour community have a resp onsibility to uphold these values.

Essential Physical Job Functions: Certain jobs at Duke University andDuke University Healt h System may include essential job functions thatrequire specific physic al and/or mental abilities. Additionalinformation and provision for requ ests for reasonable accommodation willbe provided by each hiring departm ent.

Education

Work requires knowle dge of basic grammar and mathematical principlesnormally required throug h a high school education. Two-year collegedegree preferred.

Experience

A minimum of three years direct customer service or c all centeroperations experience is required. A healthcare background w orking inmedical billing, collections, insurance claims processing, codi ng,registration, working in a medical organization, or like experience i nthe fields of education, training, training development, is highlyprefe rred.Inbound to outbound call center experience preferred.Working knowle dge of Maestro Care system preferred.

Degrees, Licensures, Certif ications

N/A

Duke is an 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 (including pregnancy and pregnancy related conditions), sexual orientation or military status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends onthe 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 essential job 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.