Claim Associate Jobs in Raleigh, NC (NOW HIRING)

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 HomeCare & Hospice
Pursue your passion for caring with Duke HomeCare & Hospice, which offers hospice, home health, and infusion services across the region, as well as serves as the home forthe Duke Caregiver Support Program. Team members work closely with a patient's physician to provide comprehensive, individualized care in the comfort of their home or at our inpatient hospice facility in Durham, NC.
POSITION SUMMARY
Responsible for performing the reimbursement functions of billing and collections through evaluation, documentation and obtaining any information required to insure complete accuracy in creating a claim and collecting from a pay source. The Patient Account Associate position can also function in the roll for cash application and the responsibilities tied to this function. This position must be able to work independently to process complex patient medical claims by therapy and payer specifications to assure accurate and timely claim submission and follow up through final payment and cash posting.
POSITION RESPONSIBILITIES

• Insures confidentiality of patient information through HIPAA Compliance.
• Maintains knowledge base on changes to reimbursement, including but not limited to specific managed care contracts, Medicare/Medicaid guidelines, and third party insurance payers.
• Initiates appropriately timed correspondence and telephone contact to clarify and explain account or coverage situation with patients or guarantors, employers, insurance companies, and sponsoring agencies; obtains cooperation toward settlement of account.
• Maintains accountability for the prompt processing of claims including billing, claims transmission, and the collection of those claims, for a set group of accounts assigned.
• Obtains and follows up on all documentation needed in order to bill.
• Notifies supervisor and data manager regarding any medical documentation requested by payer sources, or patients.
• Investigates denials from insurance companies to insure claim resolution.
• Prioritizes accounts to maximize dollars in collections.
• Notifies supervisor of problem accounts and/or clinical issues that need to be addressed related to billing and collections.
• Researches and resolves delinquent accounts to insure timely collections and reduce DSO.
• Clearly notates databases as specified by supervisor.
• Submits appropriate documentation for adjustments, write-offs, refunds or bad debt to the appropriate Supervisor, Accounts Receivable.
• Communicates to supervisor any IT issues.
• If Patient Account Associate is assigned to the cash application function, that party accurately and efficiently performs all duties related to the cash application function as outlined by supervisor.
• Performs special projects as assigned and other duties as requested.

QUALIFICATIONS
Education Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some post-secondary education preferred; additional training or working knowledge of related business.
DHCH preferred requirements are:
High school diploma or equivalent.
Understanding of medical terminology, coding, third party benefits, government payer regulations, collection techniques, and cash management experience, is preferred.
Must be computer literate. Excel experience is a plus.
Experience
Two years' experience working in hospital access, physician office or billing and collections or an equivalent combination of relevant education and/or experience. A general knowledge related to government payer regulations and third party payer guidelines is helpful.
DHCH preferred requirements are:
A minimum of two years' experience in billing and reimbursement, preferably in a health care setting, or an equivalent combination of relevant education and/or experience. A general knowledge related to government payer regulations and third party payer guidelines is helpful. Knowledge, Skills, and Abilities: Excellent communication skills, oral and written. Ability to analyze data, perform multiple tasks and work independently. Must be able to develop and maintain professional, service-oriented working relationships with patients, pay sources, co-workers, and supervisors. Must be able to understand and comply with policies and procedures.
Knowledge, Skills, and Abilities:
Excellent communication skills, oral and written. Ability to analyze data, perform multiple tasks and work independently. Must be able to develop and maintain professional, service-oriented working relationships with patients, pay sources, co-workers, and supervisors. Must be able to understand and comply with policies and procedures.To perform this position successfully, an individual must be able to perform each essential duty satisfactorily. The individual must be detail-oriented and possess time management, analytical, and organizational skills. The individual must be an independent worker. The requirements listed below are representative of the knowledge, skill, and/or ability required.
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.