Location: Durham, NC
Company: Duke Health
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. The Patient Service Associate is an integral part of the patient care team in the clinic /service area. The Patient Service Associate is responsible for patient registration activities including patient identi fication,
documentation of any special needs (language, mobility or othe r ADA identified needs), demographic and insurance updates. The PSA must ensure all financial and compliance related documents are completed and documented, check-in, check-out, point of service collections (deductib le, copay, coinsurance, and balances), referral and order management, ap pointment coordination/scheduling, work queue management, My Chart enroll ment and cash management according to established policies and procedure s.
The Patient Service Associate is expected to follow all regulatory an d compliance policies. The Patient Service Associate is also responsible for living Duke's values and demonstrating expected
behaviors while con tributing to creating a positive patient experience and building a posit ive work environment.
The Patient Service Associate will maintain a prof essional image in appearance and over the phone. The Patient Service backociate contributes to ensuring the registration desk and waiting areas s afeguard patient privacy, confidentiality and safety and are well mainta ined and clean. Patient Registration / Check-in / Check-out 1. Correctly identify patient by checking an approved photo ID and utilizing a minim um of 2 approved patient identifiers. Follow Red Flag procedure for pati ents unable to identify / verify. 2. Verify, capture, and update demogra phic information to include name, address, phone number, emergency conta ct, guarantor, race, ethnicity, veteran status, employer, primary care p rovider and / or referring provider, primary language and religious pref erence in Maestro Care as needed.
Ensure all information is complete. 3. Verify, capture / update insurance information; determine and select in surance carrier, enter subscriber information, and plan information. Run RTE (Real Time Eligibility) for any updates or changes to insurance and verify benefits for reimbursement. 4. Review / resolve eligibility edit s, coordination of benefits, data mismatch, and content errors.
Appropri ately document in medical record. 5. Capture and appropriately document patients with special needs, for example risk for falls, interpreter, sh ort of stature. Communicate with clinical staff and correctly align spec ial needs fields with any ambulatory documentation conflicts to minimize risks and meet joint commission standards. 6. Present and educate patie nts on financial, compliance, and authorization forms and obtain all nec essary signatures as required per policy. (For example, COA/COT, MSPQ, A BN, and Self-Administered Drugs.
) Appropriately label, scan, and documen t to medical record for retention. Modify communication to ensure patien t understanding if necessary. 7. Identify and collect patient financial liabilities (copay, coinsurance, deductibles, account balance); post app ropriately based on payment type, payment amount and method of payment. 8. Explain Financial Assistance policy to patients. Complete Medicaid sc reening questions for self-pay patients. Direct patients to Financial Ca re Counselor or Customer Service as needed for further financial counsel ing, billing questions, payment plan set up, missing authorizations for services while protecting the patient's privacy.
9. Explain billing and insurance implications for provider and hospital-based clinics to includ e the patient's responsibility of co-insurance and co-pay, and the poten tial for multiple bills. Address all questions and concerns; appropriate ly refer to FCC or Customer Service if PSA is unable to answer the quest ions. 10. Provide education, generate enrollment codes and support to en courage My Chart enrollment. Identify and assign appropriate proxy proces s in accordance with state and federal regulations to minimize inappropr iate medical record access.
11. Identify need for clinical questionnaire completion and provide to patients as needed. 12. Communicate wait time s; set patient and provider expectations; round in waiting room to ensur e a positive patient experience. Address concerns with patient; involve clinic leadership as needed. 13. Coordinateprisoner arrival through com munication with prisoner's guard and clinical staff to expedite check-in and rooming of patient to ensure patient safety. 14. During checkout pr ocess, correctly identify patient; review After Visit Summary (AVS) for patient follow ups.
Schedule return appointments; manage referrals and o rders.15. Balance cash, check, and credit card collections at the end of each day; reconcile discrepancies and prepare personal deposit f or cash manager according to cash management policies. 16. Meet Private Card Industry (PCI) standards by securing cash and credit card receipts at all times during clinic hours, following policy for obtaining and ret urn of cash bags on daily basis. 17. Obtain Imprest cash bag at the begi nning of the shift. Complete Imprest cash bag logs, void refund logs, an d receipt book logs (as needed) to meet internal control standards.
18. Resolve system-warning messages related to registration items (for examp le verification of patient coverage, review of guarantor information for billing / collections, and confirmation check list items) to ensure com pliance with billing and safety regulations. 19. Completes all work acco rding to procedures and standards. Achieve registration quality expectat ions to meet key performance indicators related to timely billing, colle ctions, patient experience and safety initiatives. 20. Safeguard sensiti ve information to maintain confidentiality and in adherence to HIPAA gui delines Scheduling 21.
Follow Financial Pathwayguidelines when scheduli ng (Out of network, self-pay, Out of County self-pay and Medicaid) ensur ing patient education for financial responsibility and payment expectati ons. 22. Schedule and coordinate new, return, lab, and study appointment s per scheduling guidelines, utilizing questionnaires as appropriate. En sure appointments are scheduled with correct providers, services, and in the proper order to respect referring provider and patient preferences to achieve efficiency during the patient visit. 23. Correctly link the s tudy orders or referral with the appropriate study, encounter, or appoin tment.
24. Provide patient with appropriate pre-visit instructions as de fined by clinical staff. In addition to pre-visit instructions, provide any necessary locations, times, provider, practice information, and fina ncial responsibility for next appointment. 25. Complete referrals (refer ral status and scheduling status) to ensure patient safety by scheduling all patient appointments. 26. Achieve schedulingquality expectations t o meet key performance indicators to maximize reimbursement, minimize de nials and promote a positive patient experience.
Work Queue Management 2 7. Prioritize and complete work residing in claim edit, patient, referra l, and orderwork queues based on criteria set by leadership to maximize clinic patient flow. 28. Monitor Orders and referral work queues to mak e sure all tests and studies are scheduled for the patient and linked if necessary. Orders and referrals not completed canresult in patient saf ety issues and negatively impact the patient and provider experience. 29. Resolve registration (100 and 150 level) billing claim edits related t o both the technical (HB) and professional (PB) clinic work queues.
Misc ellaneous / Patient Engagement and Work Culture 30. Actively participate / engage in clinic process improvement initiatives to maximize workflow efficiency and the patient experience. 31. Achieve or exceed patient ex perience expectations by remaining helpful, professional and responsive to the patient's needs. Consistently use " Words that Work" and " Relate" in daily interactions. 32. Make internal and external customer(s) and th eir needs a primary focus in one's actions at all times; develop and sus tain productive customer relationships.
33. Integrate compassion and con cern into daily work activities to deliver the best patient experience a nd support a teamwork environment for Duke staff. 34. Always present one self in a way that is consistent with Duke's values and behaviors. Treat others fairly and with respect while protecting the dignity, integrity, and rights of each person. 35. Using the approved service recovery guid elines while maintaining composure, determine the best course of action related to patientor clinic concerns and escalate as appropriate. 36. I nform clinical staff of late arrivals and identify appropriate action (f or example arrive and reschedule if necessary.
) Perform service recovery to mitigate impact to patient experience. 37. Provide directions, arran ge for patient transport, and interpreters as necessary. 38. Comply with all regulatory and compliance policies and procedures, understand and f ollow Joint Commission guidelines. 39. Manage and follow through / take action, as appropriate, to all in basket messages.40. Use availab le communication tools to communicate effectively with patients, visitor s, and Duke staff. 41. Follow clinic-scanning protocol- appropriately la bel, scan outside documents/medical records into Duke medical record.
42. Actively engage in the work culture initiatives of the clinic. Be resp ectful and considerate of others' point of view and embrace the diverse backgrounds of all within the organization. 43. Assists and supports fel low employees in their work to commit to overall organization success. 4 4. Accept accountability and ownership for all actions and behaviors tha t affect personal and organizational performance. Demonstrate a climate of trust by acknowledging own mistakes and taking responsibility for one 's action. 45. Answer incoming calls.
Identify and address caller needs, or transfer to the appropriate area that will meet the needs of the cal ler. 46. Maintain printers, copiers, and workstations. 47. Attend staff meetings and participate in all required education sessions. 48. Partici pate in all system, regulatory and policy training. Comply with all regu latory and compliance policies and procedures, understand, and follow Jo int Commission guidelines. 49. Ensure a safe environment for patients an d staff; report personal and patient safety concerns to clinic leadershi p within 24 hours of occurrence. 50.
Support and adhere to all policies and procedures related technology implementation within the clinic/servi ce areas as applicable(i. e. e Check In. etc. ) 51. Activates downtime pro cedures when system downtime occurs (phone, EHR, credit card.Etc. ) 52. A ctively engage in the Duke Quality Initiative 53. Perform other duties a s assigned by clinic leadership. Knowledge, Skills and Abilities Strong verbal and written communication. Basic PC and data entry skills. Knowledge of medical terminology and telephone etique tte. Demonstrated ability to organize and prioritize work, provide oral and written instructions, interact tactfully with customers and establis h and maintain effective relationships with others.
Must be able to appl y specific departmental policies rules and regulations relating to verif ying patient information, collecting payments and maintaining records an d forms. Level Characteristics N/A Minimum Qualifications Education Work requires knowledge of basic grammar and mathematical principles normally acquired through high school education Experience Minimum of one year of work experience in directly communicating and activities. providing service to patients or public; preferably in a healthcare related field.
Experience in effectively coordinating multiple tasks or 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, interaction, interactionual 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.
PDN-99c011cb-baab-4f1a-bec8-8dc48058b387
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