MANAGER, PATIENT REVENUE

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 Health's Patient Revenue Management Organization

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.

A/R Management: 60%

• Perform independent revenue cycle operational decisions to timely and accurately resolve complex AR issues that are impacting billing and collections.
• Manage Hospital Accounts Receivable with a strong focus on high-dollar collections, aging, payer trending, etc.
• Monitor the collection performance of DRO, cash collections, and aging through a daily, weekly, or monthly review of Dashboard DS, AR Summary Reporting, and other relevant KPIs.
• Develop and maintain a working knowledge base of relevant compliance requirements, payer billing requirements, CL aim logic, and reimbursement regulations related to hospital billing.
• Manage the timely resolution of DNBs, stop bills, claim edits, and payer rejections. Optimize clean claim rates through process improvement and reduction of edits.
• Identify root causes related to delays in payment from insurance payers. Collaborate with Payer Relations on trends found through account reviews.  
•  Research operational and system issues identified by collectors and develop/implement solutions for performance improvement
•  Oversee documentation of high-dollar issues, log payer trends, system issues, and staffing performance, with a focus on identifying process improvement opportunities.
•  Prepare a weekly report summarizing inventory statistics, staff productivity, collections performance, and accounts receivable aging trends
• Identify deficiencies in staff performance and backlogs in inventory statistics promptly and take action to address outstanding issues
• Work with denial Analysts and other departmental analysts  to monitor denial rate trends and identify and implement opportunities to reduce post-billing denial rates< /p>
•  Review and approve write-off requests per policy.  Provide feedback to the supervisor and staff if write-of requests are not in compliance with policy requirements
•  Review avoidable write-off trends and identify & implement opportunities to reduce avoidable write-offs.
•  Work with other PRMO management and DUHS leaders to improve collections, reduce accounts receivable, reduce claim edits, improve clean claim rate, reduce denial rates, and reduce avoidable write-offs through issue identification, research, communication, and process improvement
•  Define criteria and set up for insurance work queues to ensure timely and comprehensive collection of all accounts receivable
• ·Monitor work queues daily to ensure appropriate workflow priorities are maintained
•  Assign staff to all insurance work queues to ensure appropriate and equitable resource allocation and prioritization of outstanding workload
• Prepare a monthly summary of accounts receivable by the entity, division, or payer for director review, with an explanation for changes in performance and specific plans to address deficiencies
• Develop and maintain documentation summarizing workflow processes and operating policies and procedures related to hospital collections.
• Develop internal controls for all operational processes and ensure the timely completion of internal control processes by staff, supervisors, analysts, and/or managers.

• Oversee supervisor’s efforts in posting, recruiting, and hiring new employees
• Oversee supervisor’s efforts to provide job-specific training to new and existing employees
• Oversee supervisor’s mid-year and year-end performance evaluations of employees
• Oversee Analyst efforts to analyze, trend, identify, and resolve A-R issues for the team
• Post, recruit and hire direct reports
• Provide job-specific training to new and existing direct reports
• Conduct mid-year and year-end performance evaluations and provide feedback to direct reports
• Review results of monthly employee quality reviews and take action on underperforming staff results
• Ensure and monitor that all direct reports and associated staff receive a minimum of 40 hours per year of continuing education and training
•  Assist with the development of job-specific training programs for all staff within the team
•  Identify and implement programs to develop direct reports and associated staff for career development
• Hold weekly team meetings to review team performance, share new policies and procedures, and keep employees informed about PRMO updates
• Identify and implement opportunities for improvement of staff morale
• Hold weekly round-table sessions with all supervisors and staff to ensure positive communication and trending
• Ensure compliance with all PRMO and DUHS personnel policies

• Prepare and submit for approval an annual budget for the team
• Review actual vs. budgeted variances every month and provide a summary of explanation to the senior manager and director
• Identify negative budget variances and provide an explanation and gameplan for addressing deficiencies
•  Identify opportunities to reduce or minimize personnel and non-personnel costs
•  Respond to inquiries from PRMO and DUHS leadership, peers, and staff in a timely, accurate, and comprehensive manner (ie: 24-48 hours, depending on circumstances)
•  Adhere to all PRMO and DUHS revenue cycle policies and regulations
• Respect and maintain confidentiality regarding patient/guarantor financial data and patient medical data in accordance with HIPAA standards
•  Provide coverage for the Director in her/his absence
•  Provide coverage for the supervisor in her/his absence
• Responsibility for all supervisory responsibilities on smaller teams that do not have a supervisor
• Other duties, as assigned

A bachelor's degree is required. A master's degree is preferred.

Work requires 5 years of experience in business or other applicable experience. A master's degree in a related field, such as business or health administration, may be substituted for experience on a 1:1 basis.

Certifications in patient access or patient accounting are preferred.

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.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

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.