PRMO:, established in 2001, Patient Revenue Management Organization (PRMO) is a fully integrated, centralized revenue cycle organization supporting all of Duke Health, including Duke University Hospital, Duke Regional Hospital, Duke Raleigh Hospital, the Private Diagnostic Clinic, and Duke PrimaryCare. The PRMO focuses on streamlining the revenue cycle through enhanced management of scheduling, registration, coding, HIM operations, billing, collections, cash management, and customer service. The Mission of the PRMO is delivering quality service by enhancing the patient experience, providing financial security, and preserving Duke's reputation and mission of advancing health together. Our Vision is to be recognized as a world class innovative revenue cycle organization that values our people, patients and performance.

Hours - M-F 8am-5pm 

PATIENT ACCOUNT ASSOCIATE< /span> PROVIDER ENROLLMENT

Job Description

General Description of the Job Class

< p>The Pro vider Enrollment (PE) Specialist< span> is responsible for p reparing and submitting enrollmen t applications and supporting documentation for the p urpose of enrolling individualphysicians, physician groups < /span>and hospitals.  The PESpecialist researches and resolves billing issues related  to Provider Enrollment. A variety of systems andexternal tools are utilized in order to research and resolve provi der enrollment issues. The< /span>Provider Enrollment Specialist will be required to interact with Senior Management,  Business and Revenue Managers and Operational Personnel.

Duties and Responsibilities of this Level

90%

• Works closely with clinical departments on notification of a provider's start date, welcome packets, pro vider documentation and ensuring the provider is in all sys tems.

• Researches and resolves bill holds rel ated to provider enrollment.

• Up dates billing system to define billing and service provider effectiveand termination dates, create payer specific bill holds, NPI and NPI subpart numbers, taxonomy codes andpaye r specific provider numbers.Remov al of bill holds at the completion of enrollment by< /span>payer.

• Monitors and advises physicians and providers on license expirations.

• < p>Performs follow-up with i nsurance payersvia phone, email or website to resolve provider enrollmen t issues.

• Monitor the completion and submission of provider enrollment applications for in dividual providers, clinics and h ospitals.

• Assign reminders and follow-up to ensure< span> provider numbers are established and linked to the appropriate group entity in atimely manner.

• Understand specific en rollment requirements for each payer and provider type including < /span>pre­ requisites, forms required, form completion requirement s, supporting documentation (DEA, CV, etc.), and regulations.

• Maintain documentation of enrollment packets orspreadsheets related to enrolling Physicians < /span>and the present status of the packet.

• Work provider enrollment denial work queues toensure timely response for resolutionand provide input to Supervisor on denials we can reduce.

• < li>

  Establish close working relationships with provider enrollme nt packet contacts, contracting department, clinicaldepartments, and payer contacts.

• Respond tointernal and external inquiries on routine enrollment, as appropria te.

• Interfaces regularly with internal staff in AIR ,Registration andPayer Relations.

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  Maintain a strict level of confidentiality for all matters pertaining to provider credentials.

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OTHER: 10%

• Assists with a variety of special projects.

• Performs other dutiesas assigned.

Minimum Qualifications

Education

Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some postsecondary education preferred.Additional training or working knowledge of related business

Experience

Two years experience working in hospital access, physician office or billing and collections or an equivalent combination of relevant education and/or experience.

Degrees, Licensures, Certifications

N/A

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.