About The Position

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. Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is the 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 for Duke Health. General Description of the Job Class Reporting to the PRMO Senior Revenue Manager, the revenue manager coordinates activities performed by the staff responsible for charge capture, coding, charge entry, insurance follow up, reimbursement analysis, or other PRMO function within the assigned clinical area.  Monitor performance for staff responsible for appointment scheduling, registration, clinic check-in, and clinic collections.  Develop and prepare/utilize reports to track financial and operational performance across the entire spectrum of the revenue cycle for assigned clinical area. Review and recommend changes/updates to the departments charge master(s) to maintain fees at levels that maximize reimbursement. Review and recommend changes to department's charge capture documents to facilitate accurate and comprehensive billing in compliance with annual CPT/HCPCS and ICD-10 updates.  Identify revenue cycle problems, research/analyze data to resolve issues, identify and select alternatives to address outstanding issues, and implement solutions for improvement.  Work with financial analyst, physicians, and administrative leadership to educate and train providers and staff about coding and other outstanding revenue cycle issues.  Act as a liaison to management and staff in the designated clinical area, Patient Revenue Management Organization (PRMO), Duke University Health System (DUHS), Duke Health Integrated Practice, and third-party payers on revenue cycle activities for assigned areas. Continuously research, monitor, provide education and implement payer regulations and guidelines related to revenue management activities of the assigned clinical area. Coordinate revenue management orientation and educational activities of clinical personnel including providers and staff about coding and other outstanding revenue cycle issues. Develop and utilize management models to monitor productivity and quality of staff performance. Train, direct, and coordinate activities of assigned financial analyst /or other employees. Perform other related duties incidental to the work described herein. The PRMO Revenue Manager serves as a liaison among PRMO, Operational Owners and Maestro Care Clinical/Billing analysts to assist in the design, development, maintenance, training and evaluation for assigned Maestro Care clinical and business systems to support the revenue cycle. This position will be primarily responsible for design/re-design of workflow, working with Maestro Care Build teams, testing, and validating of application functionality specifically related to charge capture/billing. This position will coordinate all revenue cycle issues that arise for their application area and must be very knowledgeable of DUHS/PRMO policies, procedures, and business operations.

Requirements

  • Bachelor’s degree required. Master’s degree preferred.
  • At least 6+ years of relevant Healthcare Care experience preferably in Charge Integrity/Revenue Management is required.
  • Coding certification (e.g. CCS, CPC, RHIA, RHIT), HFMA CHFP (Certified Healthcare Professional), CRCR (Certified Revenue Cycle Representative), or BSN RN preferred.
  • Strong leadership capabilities with demonstrated ability to lead, motivate, and collaborate effectively with Hospital leadership.
  • Strong oral and written communication skills.
  • Excellent problem solving, analytical, and technical troubleshooting skills.
  • Prioritization skills and ability to manage multiple projects concurrently.
  • Ability to work on a flexible schedule
  • Strong research and documentation skills.
  • Ability to work independently
  • Intermediate to expert in Microsoft Excel, PowerPoint, Teams, Word, Visio and Outlook

Responsibilities

  • Manage revenue cycle-related inquiries
  • Monitor & manage from key performance indicators
  • Monitor & manage reimbursement changes
  • Facilitate revenue cycle collaboration and strategic planning activities
  • Coordinate and chair revenue-oriented workgroup activities and meeting
  • Manage communications among PRMO, hospitals, and physician practices
  • Arrange revenue cycle training activities
  • Manage revenue and/or compliance requests
  • Develop and manage action plans & timelines
  • Identify and recruit appropriate resources
  • Develop creative solutions
  • Specialize & manage revenue cycle functions and Epic Systems applications
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