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 PrimaryCare. 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.
ANALYST, IT - REVENUE CYCLE
Resolute SBO certified
Tasks of requesting, testing and implementing changes to Charge Router and Charge Review, Follow-Up, Account and Claims Work Queues for Professional and Hospital Billing. Liaison between Revenue Management and the Maestro Care team for development, deployment, support, testing and implementing changes of the Maestro Care Resolute PB and HB build.
Completes testing and implementing build activities as directed and provide additional expertise in the areas of design, build, testing and billing processes.
Liaison for Revenue Management to Maestro Care Team to provide hands-on support to the Maestro Care PB and HB Teams
Responsible for overseeing all Service Now requests for Revenue Management Department, excluding Clinical Research
Overseeing all Charge Router-Review logic updates and Charge Router Review Work Queues
Collaborate with management and end users to request, test, and implement changes to the Charge Router for compliant billing
Responsible for Revenue Management support of Account, Follow-Up and Claim Edit Work Queues and Billing related components in Master Files for DEP updates(e.g., charging method, POS, linked technical charges)
Oversee Preference List updates for both Ambulatory and Inpatient
Oversee specific Charge Router, Error Pool and PB/HB Work Queues
Monitoring of specific PB Charge Review Work Queues for system updates
Review release notes related to current and new functionality. Report, document and escalate issues.
Epic upgrade/new version testing, validation and implementation
Communicate upgrade release notes/quick tips to Revenue Management
Notification to Revenue Management of new/updated PB Charge Review rules
Formally participate and initiate meetings for review of billing issues and/or system logic updates identifying scope changes and raise issues or risks when discovered
Manage the documentation, resolution and completion of identified deployment issues and tasks to include maintaining accuracy for Internal Controls initiative
Develop and document system and user procedures as necessary and provide system production support including the analysis, prioritization and implementation of requested change
Responsible for support, performing LCD/NCD/KB updates, system upgrades, rule writing, trouble shooting, testing and implementing changes to the Claims Manager (Optum) professional coding billing system
Responsible for support for updates, troubleshooting issues, testing and implementation of the CodeRyte Code Assist software to include software and interface support
Responsible for validating receipt of, correcting errors and daily tracking of departmental billing system interfaces within Epic
Responsible for new DEP testing, including dropping charges from EpicCare and working with analysts from other areas to test build, i.e Radiant, Beaker, etc. and following through to the Claim
Maintain requests for additions/removals of bill areas in provider SER records
Fee Schedule Group updates for new DEPs/Providers
Education: Bachelor's Degree or 4 years experience equivalet to a degree.
Experience: 4 years revenue cycle experience, EPIC certification (Preferred).
*The EPIC certification/proficiency will be a requirement within the first 6 months of hire.
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.
As a world-class academic and health care system, Duke Health strives to transform medicine and health locally and globally through innovative scientific research, rapid translation of breakthrough discoveries, educating future clinical and scientific leaders, advocating and practicing evidence-based medicine to improve community health, and leading efforts to eliminate health inequalities.