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.
General Description of the Job Class
Implement and maintain Compliance programs in accordance with the Office of Inspector General's work plan, to reduce institutional and individual provider legal and financial risk through education and internal audits.
Duties and Responsibilities of this Level
Educate providers, HIM Coders and Strategic Customers (inclusive of vendors, CDI, and DUHS affiliates) with regard to the best practices for inpatient and outpatient Coding and Billing and documentation according to and in compliance with government regulations with special attention to Center for Medicare and Medicaid guidelines, HIPAA, and Fraud and Abuse with periodic updates around AHA (America Hospital Association) standards. (30%)
Assist in performing analysis of current situations and recommend priorities and goals for future HIM coding needs. Identify coding and billing risk areas, conduct focused reviews, and implement recommended action plans and education as needed. (20%)
Assist in the coordination of Technical Coding Integrity QA staff by engaging in HIM coding, abstracting and medical data research to include review and analysis of data inputs, processing and data output activities. Develop and present workflow enhancement opportunities and participate in educational training programs to Hospital and Duke Staff. (30%)
As a world-class academic and health care system, Duke Health strives to transform medicine and health locally and globally through innovative scientific research, rapid translation of breakthrough discoveries, educating future clinical and scientific leaders, advocating and practicing evidence-based medicine to improve community health, and leading efforts to eliminate health inequalities.