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Patient Account Associate - Duke Lab Services

PRMO Full Time Durham, North Carolina
Requisition Number: 249612
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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.

ONSITE POSITION: (Monday - Friday: 11:00am - 7:30pm)

General Responsibilities and Task:

Gen Code Test Billing:

Analysis of lab test orders in relation to contracts with external labs for billing and application of CMS rules and contractual obligations. Ensure information provided by Referral Lab Technologists is correct (QA billing, in formation provided with requisitions, such as patient insurance, date, etc. Ensure correct price and CPT codes for the test that has been ordered ). Applying CMS rules for billing determination. Ensure correct billing information is provided to external laboratories. Ensure correct account information is included for claims. Enter the appropriate CPT codes and prices for Gen Code test billing using EPIC work ques.

HB and PB Claim Edits:

Clear 15 PB an d2 HB Clinical Lab claim edits to ensure correct and timely billing for tests to reduce the risk of denials and unexpected bills for the patient.

Other:

  • Perform prior authorizations on Molecular tests for UH, BCBS, Tricare.
  • Prepare spreadsheet with new Referral Lab Molecular test s for the UHC registry for prior authorizations and maintain test accuracy of the registry.
  • Perform price estimates on Ge n Code tests for Duke Clinics throughout the Health System.

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 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

N/A

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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.

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Serving With Purpose

You’ve always been called to care – and we share your dedication to making a meaningful difference in the community. With the entire team united through this purpose, there are no limits to what we can achieve together. You’ll have all the resources you need here to leave a legacy of exceptional service because at Duke Health we support you in your calling to care.

Awards and Recognition

Duke Health is consistently recognized as a top employer for our dedication to the team members and the patients we serve.

Forbes list

On Forbes list of Best Large Employers, we are the #1 healthcare recipient in North Carolina for 2023.

LGBTQ Recognition

Our hospitals are consistently recognized as LGBTQ Healthcare Equality Leaders by Healthcare Equality Index.

Magnet Recognition

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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CHIME Digital Health Most Wired recipient since 2018, honoring our ability to elevate the health and care of communities around the world.

Magnet Recognition
We are proud to be named a top healthcare system in North Carolina on Fortune’s 2024 list of America’s Most Innovative Companies.

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