What are the responsibilities and job description for the REVENUE MANAGER-Remote position at Duke?
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.
The PRMO Revenue Manager serves as a liaison among PRMO, Operational Owners and Maestro Care Clinical/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/re-design 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.
Revenue Management
Key Accountabilities
- Manage revenue cycle-related inquiries.
- Serve as Point Person/Service Line Resource (Liaison)
- Respond, research and resolve revenue cycle-related inquiries pertaining to assigned Maestro Care applications.
- Must be able to communicate effectively, provide timely responses, identify resources to resolve inquiries.
- Monitor and manage from 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 WQs.
- Monitor and manage key performance indicators.
- Utilize standard reports and/or develop new reports to track revenue cycle performance for assigned application clinical services.
- Areas of focus will include denial rates, avoidable write-off, and full transaction write-offs, deleted charges.
- Will also perform ad hoc analyses as requested, e.g., high- dollar drug reimbursement; service/program/code specific reimbursement; actual charge to budget charge variance.
- Review key metrics, from scheduling to billing & collections, in collaboration with PRMO Managers.
- Identify issues through ongoing monitoring of departmental metrics and/or through routine meetings with key operational managers within PRMO to facilitate communication.
- Monitor & manage reimbursement changes.
- Continuously research and monitor payer regulations; provide education to operational areas.
- As applicable, coordinate with DHIP Revenue Managers to educate physicians to meet changing payer requirements/regulations.
- Other duties as assigned.
Percent of Time
30%
Revenue Cycle Leadership
Key Accountabilities
- Facilitate revenue cycle collaboration and strategic planning activities.
- Serve as Duke Revenue Cycle Management and Integration lead for assigned areas to coordinate activities (reduce redundancies) and keep senior leadership informed.
- Coordinate and chair revenue-oriented workgroup activities and meetings.
- Manage communications among PRMO, hospitals, and physician practices.
- Must be able to facilitate meeting 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.
- Coordinate and chair revenue- oriented workgroup activities and meetings.
- Share operational changes to and from PRMO to hospital and physician practices.
- Develop or participate in focused workgroups to address topics such as registration, billing & collections, coding and charge capture, Maestro Care applications.
- Facilitate discussions and strategies to address operational issues.
- Managing communications between PRMO and Hospital Operational Owners and Providers.
- Organize and lead workgroups to routinely meet with Operations regarding PRMO function, issues, trends, etc., affecting revenue cycle performance.
- Actively participate in service line specific strategic planning around revenue cycle prioritization and planning.
- Arrange revenue cycle training activities.
- Maintain exceptional customer service, fortifying expectation of consistent professionalism and expertise.
- Must be capable of setting priorities and working under pressure.
- Coordinated activities are expected to be carried out with minor supervision.
- Escalate issues as needed.
- Other duties as assigned.
Percent of Time
30%
Project Management
Key Accountabilities
- Manage and prioritize revenue and/or compliance requests.
- Manage projects simultaneously.
- Develop and manage action plans and maintain timelines.
- Organize and keep deadlines.
- Identify and recruit appropriate resources.
- Develop and maintain strong relationships.
- Develop creative solutions.
- Must be process oriented.
- Manage Annual CPT Updates: Coordinate, working with Health System Operations Managers in assigned applications: DUHS Revenue Management and PRMO
CDM Team, Hospital Finance, and PDC Revenue Managers; including Annual review of charges and DEPs.
- Investigate and manage revenue opportunities identified through reporting and analysis.
- Other duties as assigned.
Percent of Time
30%
Epic Systems Advisory
Key Accountabilities
- Specialize and manage revenue cycle functions and Epic Systems applications.
- Manage assigned Service Now tickets.
- Must be able to investigate charge and claim information and navigate information systems.
- Serve as EPIC System knowledge source for charge capture functions (charge capture, reconciliation, and corrections for procedures, medications, and supplies as appropriate) with specific applications.
- Other duties as assigned.
Percent of Time
10%
Minimum Qualifications
Ideal candidates will be able to balance the above tasks while maintaining flexible, friendly interaction with Operational and Hospital Leadership. The ability to work independently, proactively and adapt appropriately to changing priorities is a must.
Education
Bachelor’s degree required. Master’s degree preferred.
Experience
At least 6 years of relevant Healthcare Care experience preferably in Charge Integrity is required.
Strong leadership capabilities with demonstrated ability to lead, motivate, and collaborate effectively with Hospital leadership.
Strong oral and written communication skills.
Degrees, Licensures, Certifications
Coding certification (e.g. CCS, CPC, RHIA, RHIT), HFMA CHFP (Certified Healthcare Professional), CRCR (Certified Revenue Cycle Representative) preferred.
Duke is an 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 (including pregnancy and pregnancy related conditions), sexual orientation or military 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 essential job 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.