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
Independently performs specialized or advanced health information activities necessary to organize, maintain, and use electronic patient health records. Activities required include research, analysis and compilation of findings into summarized reports that will be shared within and external to the Health Information Management Department. Positions at this level have high customer service, strong analytic and problem solving skills, require interpretation and explanation of policy and external requirements related to, privacy, release of information, positive patient identity, and other department and organization-wide functions. Specific job responsibilities are based on the service unit within Health Information Management assigned. Expert computer skills to navigate and query multiple electronic record systems.
Release of Information: regular interaction required with patients, attorneys, and governmental agencies, providers of health care, insurance companies, auditing agencies, and researchers. Detailed working knowledge and ability to apply HIPAA rules, North Carolina General Statutes, and other State and Federal laws regarding patient privacy.
Patient Identity Management: regular interactions required with patients, attorneys, insurance companies, providers of healthcare and governmental agencies. Detailed working knowledge and ability to apply State and Federal laws regarding positive patient identification, identity theft, vital records regulations, Joint Commission requirements, and CMS guidelines and rules.
Duties and Responsibilities of this Level
Patient Identity Management Functions:
Coordinates Chart Correction Cases within Maestro Care including evaluation of help desk requests, assignment of correction tasks and verification completion and closure of the case and verifies completion and closure of the case. (25%)
Performs concurrent and retrospective contact moves. Analyzes the content of health record document, coordinates with responsible providers, clinicians, and ancillary department participating in the patient's care for record correction requirements to resolution. (25%)
Maintains an accurate Enterprise Master Patient Index (EMPI) through active research and comparison of potential duplicates and clinical history to resolve patient identification discrepancies including necessary investigation of potential identity theft. Performs name and demographic changes with supporting documentation. (10%)
Track, monitor and validate patient overlays that occur during patient registration and scheduling activities. Analyze and trend data for feedback to appropriate department. Notifies compliance and affected departments of incorrect documentation location. (10%)
Leads clinical, ancillary and financial staff to assist in resolving overlay issues of multiple patient information in one medical record to resolve overlay resolution within 24 hours of discovery of overlay. Participates in 24-hour on-call rotation. (15%)
Maintains enterprise master patient index integrity medical record number merges, un-merges and medical record number assignments electronically. Performs name and demographic changes with supporting documentation. (5%)
Works with management to compile and review trending reports for Patient Identity functions. Assists with preparation of procedure documentation to support processes and training (5%)
Performs other duties as assigned, including Customer Service focus in training providers, internal and external customers on Chart Correction / Support Ticket resolution. (5%)
Required Qualifications at this Level
Associate's degree in a health information management required
2 years' experience in Health Information Management required
Bachelor's Degree in HIT or RHIT can substitute for 2 years' experience
Bachelor's Degree in HIT Preferred
Degrees, Licensure, and/or Certification:
RHIT or eligible to sit.
RHIT must be obtained within 6 months of hire.
Knowledge, Skills, and Abilities:
Good organizational skills, excellent investigative/analytic skills with detail orientation, and strong follow-through capabilities.
Excellent verbal and written communication skills in order to effectively problem solve, develop working relationships and assist system users.
Must be able to meet deadlines, work independently, set priorities and maintain confidentiality.
Ability to work calmly and efficiently in high-pressure situations.
Intermediate knowledge of human anatomy and physiology and medical terminology highly preferred.
Intermediate to Expert skills using Windows-based software, familiarity with information technology hardware and software in a local and wide area network environment.
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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.
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.