Reimbursement Specialist - Duke Raleigh Hospital - Full Time

Duke Careers - Raleigh, NC

Duke Raleigh Hospital offers the latest in care and technology in a patient-friendly setting. It has been an important part of Duke Health since 1998 and has served Wake County for more than 35 years, employing more than 1,300 people.The hospital provides 186 inpatient beds and a comprehensive array of services, including the Duke Raleigh Cancer Center, Duke Raleigh Orthopedic and Spine Center, cardiovascular services, neurosciences including the Duke Raleigh Skull Base and Cerebrovascular Center, advanced digestive care, disease management and prevention, wound healing, outpatient imaging, intensive and progressive care, pain clinic, same-day surgery, emergency department and community outreach and education programs. In fiscal year2018, Duke Raleigh Hospital admitted 9,484 patients and had 230,957 outpatient visits in fiscal year 2017.

U.S. News & World Report ranked Duke Raleigh Hospital as #14 in North Carolina and #6 in the Raleigh-Durham area for 2018-19.
Occ Summary
Compile, analyze and report on the performance of departmental operatingunits, noting trends and making recommendations o r conclusions regardingprogress.
Work Performed
Analy ze and provide feedback for departmental specific reports.Utilizes clini cal and coding knowledge to ensure accurate and compliantcharge items an d to recognize and resolve billing inconsistencies.Coordinates projects and audits to improve processes related to revenuecycle, efficiency of charging and billing, and collection efforts.Assist management in forecas ting by providing historical information.Work with departmental director s, managers and appropriate personnel toensure budgetary compliance.Mana ge appropriate systems for accountsreceivable and/or financialreporting and prepare written reports and analyses for PRMO, DUHS andPDC leadersh ip documenting trends and appropriaterecommendations/conclusions.Coordin ate communication between insurance companies, governmentalagencies, providers and support staff.Trend and report on departmental performance in dicators and goals.Ensure departmental goals are satisfied.Make recommen dations to improve financial systems; perform in houseaudits of operatin g units; analyze deficiencies and report tomanager/director.Assist in de veloping and defining short and long term departmentalspecific goals and objectives.May be responsible for managing and delegating database inqu iries.Creation and development of work assignments including training ofemployees.Maintain professional relationship with internal and external agenciesand professional organizations concerning operations.May serve a s liaison between the physicians and the PRMO.May conduct employee quali ty reviews in support of OER (OverallEffectiveness Rating) performance e valuations, and provide feedback tomanagement and relevant employees.Dev elop and provide job-specific training to new and existing employeeswith in department.Perform other related duties incidental to the work described herein.
Knowledge, Skills and Abilities
Data anal ysis and reportingBilling/CollectionsInsurance ClaimsMicrosoft Office (E xcel, Access, Word, Powerpoint)Good communication skills (verbal and wri tten) are essential.
Level Characteristics

Minimum Qualifications

High school diploma or equivalent is required, preferably supplemented by post-secondary courses in Accounting, Finance, Economics, Business Administration or a related field.
Four years of related experience in healthcare is required. A Bachelor's degree in a related field can substitute for the experience requirement.
Degrees, Licensures, Certifications

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.

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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.