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.
The Revenue Manager will oversee the revenue cycle activities associated with services of the Pharmacy Service Line, with the goal of maximizing reimbursement in a cost-effective manner that is in compliance with federal/state and payer-specific billing requirements.
Coordinate activities of staff responsible for charge capture, coding, charge entry, insurance follow up, reimbursement analysis, or other PRMO function for 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 annualCPT-4 and ICD-9 updates. Identify revenue cycle problems, research/analyze data to resolve issues, identify and select alternatives to address outstanding issues, and implement solution s 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, PDC, PRMO, DUHS Hospitals, 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. Develop and manage the budget for the staff and activities that are directly managed. Train, direct, and coordinate activities of assigned financial analyst/or other employees. Perform other related duties incidental to the work described herein.
Knowledge, Skills and Abilities
Experience in these areas is preferred: CPT/ICD/9 Coding, reimbursement s stems including IDX, TES, Medicode, PAS, financial analytical skills, spreadsheet, database, APC, DRG, and third party reimbursement guidelines and procedures.
Experience Six years of experience in the healthcare industry is required. Pharmacy and Revenue Cycle Background preferred.
Degrees, Licensures, Certifications BA, BBA, RN, CPC, RRA, or CPA, or higher
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