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 Primary Care. 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 Dukeâ€™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.
Duke University Health System - Patient Revenue Management Office (PRMO) seeks to hire an experienced Senior Revenue Manager who will embrace our mission of Advancing Health Together.
General Description of the Job Class
The Senior Revenue Manager will manage and coordinate the revenue cycle activities. Duties and Responsibilities of this Level assigned incidental to the work activities associated with the assigned Revenue Manager(s), with the goal of providing strategic direction to maximize reimbursement, establishing and monitoring revenue cycle activities in a cost-effective manner, in compliance with federal and state laws, and payer-specific billing requirements.
Duties and Responsibilities of this Level
Provide strategic direction to PRMO in order to facilitate maximization of clinical revenue in a cost-effective manner.
Responsible for the oversight functions within the Revenue Integrity Department for the Hospital Revenue Managers (HRM); setting the overall direction for improvement in those areas; more specifically developing policy and procedures for monitoring of unmapped coding/charge review and HRM charge capture methodologies for identifying and validating tools, reviews, edits and claims are appropriate
The Sr. Revenue Manager serves as the primary contact between Practices/Hospital leaders and the Central Billing Office (CBO) for all aspects of the billing and collection of professional/hospital services. Working closely with the Directors of Revenue Cycle, the Sr. Revenue Manager is responsible for the proactive management of all clients. Management of the relationship requires full assessment and understanding of the department's revenue cycle, including a thorough understanding of systems, processes and services specific coding and billing requirements, proactive identification of opportunities for revenue cycle improvement initiatives, and development of plans to implement process improvements.
The Sr. Revenue Manger will proactively identify issues and opportunities for improvement as well as follow-up on department concerns.
Oversee the revenue cycle activities associated with assigned clinical areas.
Developing and utilizing applicable management models to oversee productivity and overall quality of staff performance
Monitor financial targets, trends and develop action plans working with members of applicable teams to correct or improve any variances; to include DRaH, DUH and DRH finance, compliance and operational areas/module; serving as a resource for answering and delegating RCM, charge review/edit and module information to ensure maximum reimbursement and compliance with CDM/BS rules.
Review all KPI reports that would help identify trends, increase productivity and other improvements. Specifically EPIC Module updates and integrations within operations (Radiant, ASAP, Optime, Beaker, Willow/FAM), Revenue Guardian-Charge Capture Audit findings/reporting of outcomes charge errors, savings/losses to entities and determine improvements to be made or validity of tools usage.
Coordinate revenue management orientation and educational activities of Revenue Integrity personnel with hospital and provider affiliation, trainingand educating on billing systems, CDM, Revenue Management and other related issues to include charge capture (orderables, performables and chargeables), coding and other outstanding revenue cycle issues.
Serve as principal liaison to management and staff in designated clinical areas, PDC, PRMO, Duke Hospital's and third party payor sof revenue cycle Provide training, development and oversight of the assigned Revenue Manager(s).
Conduct performance evaluations for direct reports, assessing growth needs and project updates from assigned Revenue Manager(s) through appropriate opportunities.
Manage the coordination overall Charge Integrity projects, Revenue Integrity Committees, Annual CPT Update, System upgrades/updates. Perform other relatedd duties described herein.
Eight years of experience required, of which 5 of those years should be in the healthcare industry. Three years of management experience preferred. Coding and/or nursing clinical experience highly desired. EPIC Resolute certification highly desired.
Degrees, Licensures, Certifications
BA, BBA, RN, CPC, RRA, CPA, or higher.
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