Patient Account Associate

Duke Careers•Durham, NC

24d•Hybrid

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. About Duke HomeCare & Hospice Pursue your passion for caring with Duke HomeCare & Hospice, which offers hospice, home health, and infusion services across the region, as well as serves as the home forthe Duke Caregiver Support Program. Team members work closely with a patient's physician to provide comprehensive, individualized care in the comfort of their home or at our inpatient hospice facility in Durham, NC. Work arrangement - Hybrid 2 days per week in the office and 3 days from home. This team does not allow WFH more than 3 days in a work week. Position Summary Responsible for performing the reimbursement functions of billing and collections through evaluation, documentation and obtaining any information required to ensure complete accuracy in creating a claim and collecting from a pay source. The Patient Account Associate position can also function in the roll for cash application and the responsibilities tied to this function. This position must be able to work independently to process complex patient medical claims by therapy and payer specifications to ensure accurate and timely claim submission and follow up through final payment and cash posting.

Requirements

Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some post-secondary education preferred; additional training or working knowledge of related business.
Two years’ experience working in hospital access, a physician's office, or billing and collections or an equivalent combination of relevant education and/or experience. A general knowledge related to government payer regulations and third-party payer guidelines is helpful.
Work requires a minimum of two years’ experience in billing and reimbursement, preferably in a health care setting, or an equivalent combination of relevant education and/or experience. A general knowledge related to government payer regulations and third-party payer guidelines is helpful.
Excellent communication skills, oral and written.
Ability to analyze data, perform multiple tasks and work independently.
Must be able to develop and maintain professional, service-oriented working relationships with patients, pay sources, co-workers, and supervisors.
Must be able to understand and comply with policies and procedures.
To perform this position successfully, an individual must be able to perform each essential duty satisfactorily.
The individual must be detail-oriented and possess time management, analytical, and organizational skills.
The individual must be an independent worker.
The requirements listed below are representative of the knowledge, skill, and/or ability required.

Nice To Haves

High school diploma or equivalent.
Understanding of medical terminology, coding, third-party benefits, government payer regulations, collection techniques, and cash management experience is preferred.
Must be computer literate.
Excel experience is a plus.

Responsibilities

Ensures confidentiality of patient information through HIPAA Compliance.
Maintains a knowledge base on changes to reimbursement, including but not limited to specific managed care contracts, Medicare/Medicaid guidelines, and third-party insurance payers.
Initiates appropriately timed correspondence and telephone contact to clarify and explain account or coverage situation with patients or guarantors, employers, insurance companies, and sponsoring agencies; obtains cooperation toward settlement of account.
Maintains accountability for the prompt processing of claims, including billing, claims transmission, and the collection of those claims, for a set group of accounts assigned.
Obtains and follows up on all documentation needed to bill.
Notifies supervisor and data manager regarding any medical documentation requested by payer sources or patients.
Investigate denials from insurance companies to ensure claim resolution.
Prioritize accounts to maximize dollars in collections.
Notifies supervisor of problem accounts and/or clinical issues that need to be addressed related to billing and collections.
Research and resolve delinquent accounts to ensure timely collections and reduce DSO.
Clearly notes databases as specified by the supervisor.
Submits appropriate documentation for adjustments, write-offs, refunds or bad debt to the appropriate Supervisor, Accounts Receivable.
Communicates to the supervisor any IT issues.
If a Patient Account Associate is assigned to the cash application function, that party accurately and efficiently performs all duties related to the cash application function as outlined by supervisor.
Performs special projects as assigned and other duties as requested.