Revenue Manager-Remote

Overview

At Duke Health, we are committed 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.

Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's 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.

The PRMO Revenue Manager serves as a liaison among PRMO, Operational Owners and Maestro Care Clin/ 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/redesign 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.

• Manage revenue cycle-related inquiries.
• Respond, research and resolve revenue cycle-related inquiries pertaining to assigned Maestro Care applications.
• Communicate effectively, provide timely responses, and identify resources to resolve inquiries.
• Monitor and manage key performance indicators.
• Independently complete data analysis.
• Monitor and manage reimbursement changes.
• Interpret and implement items communicated through payer policies.
• Provide training on charge capture, reconciliation, and correction as needed.
• Resolve accounts in assigned Charge Router, Charge Review, Claim Edit, and Follow-Up Work Queues.
• Utilize standard reports and/or develop new reports to track revenue cycle performance for assigned application clinical services.
• Focus areas include denial rates, avoidable write-offs, and full transaction write-offs, deleted charges.
• Perform ad hoc analyses as requested (e.g., high-dollar reimbursement; service/program/code specific reimbursement; actual charge to budget variance).
• Review key metrics from scheduling to billing and collections in collaboration with PRMO Managers.
• Identify issues through ongoing monitoring of departmental metrics and/or routine meetings with key operational managers within PRMO to facilitate communication.
• Continuously research and monitor payer regulations; provide education to operational areas.
• Coordinate with DHIP Revenue Managers to educate physicians on changing payer requirements/regulations.
• Other duties as assigned.

Percent of Time: 30%

• Facilitate revenue cycle collaboration and strategic planning activities.
• Serve as Duke Revenue Cycle Management and Integration lead for assigned areas to coordinate activities and keep senior leadership informed.
• Coordinate and chair revenue-oriented workgroup activities and meetings.
• Manage communications among PRMO, hospitals, and physician practices.
• Facilitate meetings of multi-disciplinary teams.
• Arrange revenue cycle training activities.
• Participate in routine meetings with CFOs, AVP, Reimbursement Revenue Accounting to provide updates on current revenue cycle issues/priorities.
• Provide service line-specific strategic planning/priorities to PRMO leadership through Revenue Manager Councils/Operations Meetings.
• Share operational changes to and from PRMO to hospital and physician practices.
• Develop or participate in focused work groups to address topics such as registration, billing & collections, coding and charge capture, Maestro Care applications.
• Facilitate discussions and strategies to address operational issues.
• Manage communications between PRMO and Hospital Operational Owners and Providers.
• Organize and lead work groups to routinely meet with Operations regarding PRMO function, issues, trends, etc., affecting revenue cycle performance.
• Actively…