Reimbursement Specialist - Duke Raleigh Hospital - Full Time

Updated: about 1 month ago
Location: Raleigh, NORTH CAROLINA

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 operating units, noting trends and making recommendations or conclusions regarding progress.

Work Performed

Analyze and provide feedback for departmental specific reports. Utilizes clinical and coding knowledge to ensure accurate and compliant charge items and to recognize and resolve billing inconsistencies. Coordinates project sand audits to improve processes related to revenue cycle, efficiency of charging and billing, and collection efforts. Assist management in fore casting by providing historical information. Work with departmental directors, managers and appropriate personnel to ensure budgetary compliance. Manage appropriate systems for accounts receivable and/or financial reporting and prepare written reports and analyses for PRMO, DUHS and PDC leadership documenting trends and appropriate recommendations/conclusions. Coordinate communication between insurance companies, governmental agencies, providers and support staff. Trend and report on departmental performance indicators and goals. Ensure departmental goals are satisfied. Make recommendations to improve financial systems; perform in house audits of operating units; analyze deficiencies and report to manager/director. Assist in developing and defining short and long term departmental specific goals and objectives. May be responsible for managing and delegating database inquiries. Creation and development of work assignments including training of employees. Maintain professional relationship with internal and external agencies and professional organizations concerning operations. May serve as liaison between the physicians and the PRMO. May conduct employee quality reviews in support of OER (Overall Effectiveness Rating) performance evaluations, and provide feedback to management and relevant employees Develop and provide job-specific training to new and existing employees within department. Perform other related duties incidental to the work described here.

Knowledge, Skills and Abilities

Data analys is and reportingBilling/CollectionsInsurance ClaimsMicrosoft Office (Exc el, Access, Word, Powerpoint)Good communication skills (verbal and writt en) 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.

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.

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