REVENUE MANAGER-100% Remote

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.

This position may have the opportunity to work remotely. All Duke University remote workers must reside in one of the following states or districts: Arizona; California; Florida; Georgia; Hawaii; Illinois; Maryland; Massachusetts; Montana; New Jersey; New York; North Carolina; Pennsylvania; South Carolina; Tennessee; Texas; Virginia; or Washington, DC.

The PRMO Revenue Manager serves as a liaison among PRMOs, operational owners, and Maestro Care clinical and billing analysts to assist in the design, development, maintenance, training, and evaluation of assigned Maestro Care clinical and business systems to support the revenue cycle. This position will be primarily responsible for the design and re-design of workflow, working with Maestro Care Build teams, testing, and validating application functionality specifically related to charge capture and 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- and cycle-related inquiries.
• Serve as a point person or Resource (Liaison)
• Respond, research, and resolve revenue cycle-related inquiries about assigned Maestro Care applications.
• Must be able to 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 WQs.
• Monitor and manage key performance indicators.
• Utilize standard reports and/or develop new reports to track revenue cycle performance for assigned clinical services.
• Areas of focus will include denial rates, avoidable write-offs, full transaction write-offs, and deleted charges.
• Will also perform ad hoc analyses as requested, e.g., h-dollar drug reimbursement; service/program/code-specific reimbursement; and 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 regular meetings with key operational managers within PRMO to facilitate communication.
• Monitor & manage reimbursement changes.
• Continuously research and monitor payer regulations; provide education in operational areas.
• As applicable, coordinate with DHIP Revenue Managers to educate physicians to meet changing payer requirements/regulations.< /span>
• 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 PRMOs, hospitals, and physician practices.* Must be able to facilitate meetings of multi-disciplinary teams.* Arrange revenue cycle training activities.* Participate in routine meetings with CFOs, AVPs, and reimbursement revenue accounts to provide updates on current revenue cycle issues and priorities.* Provide service line-specific strategic planning and priorities to PRMO leadership through Revenue Manager Councils and Operational Meetings.* Coordinate and chair revenue - oriented workgroup activities and meetings.* re-operational changes to and from PRMO to hospital and physician practices.Develop or participate in focused workgroups to address topics such as registration, billing & collection, coding and charge capture, and 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 expectations of consistent professionalism and experience.* 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.
• I 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 RevenuManagement and PRMO

CDM Team, Hospital Finance, and PDC Revenue Managers, including annual reviews 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 in and manage revenue cycle functions and Epic Systems applications.
• Manage the assigned Service Now tickets.
• Must be able to investigate, charge, and claim information and navigate information systems.
• Serve as an 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, and proactively, and adapt appropriately to changing priorities is a must.

Education **

Experience**

Bachelor’s degree required. Master’s degree preferred.

At least 6+ y ears of relevant Healthcare Care experience preferably in Charge Integri ty is required.

Strong leadership capabilities with a demonstrated ability to lead, motivate, and collaborate effectively with hospital leadership.

Strong oral and written communication skills.

Degrees, licenses, and certifications

Coding certification (e.g., CCS, CPC, RHIA, RHIT), HFMA CHFP (Certified Healthcare Professional), and CRCR (Certified Revenue Cycle Representative) are preferred. **

Minimum Qualifications**

Education **

Experience**

Bachelors degree required. Masters degree preferred.

Six years of experience in the healthcare industry is required.

Degrees, Licensures, Certifications

BA, BBA, RN, CPC, RRA, or CPA, or higher

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.