Patient Service Representative – Outpatient Eligibility, Procedural Authorization

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🌲 North Carolina – Remote

🌲 North Carolina – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

👻 Ghost score 13%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Duke Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1924

💼 Consulting

🏥 Healthcare

📚 Education

Consulting • Healthcare • Education

Duke Careers is a platform connected to Duke University's rich legacy, established in 1924. It aims to celebrate the centennial of Duke University while providing resources, stories, and interviews that reflect the university's history, current achievements, and future aspirations. A key focus of Duke Careers is to engage with alumni and the community, showcasing the transformative impact of education and leadership within the university.

📋 Description

• Maintain accurate and complete patient accounts according to departmental protocols, policies, procedures, and regulatory compliance requirements • Perform pre-admission, admission, pre-registration, and registration functions • Ensure insurance requirements are met before patient arrival and inform patients of financial liability • Arrange payment options and screen patients for government funding sources • Analyze insurance coverage and benefits to ensure timely reimbursement • Obtain PACs and authorizations as appropriate • Facilitate referrals to Financial Services for uninsured patients and financial counseling • Research accident-related conditions to determine the appropriate liability or payment source • Schedule and pre-register patients; correct demographic and financial data • Resolve insurance claim rejections and denials • Remind patients about balances due, co-pays, coinsurance, and deductibles • Evaluate diagnoses for compliance with Local Medicare Review Policy • Explain billing according to PRMO credit and collection policies • Implement collection actions and assist financially responsible persons with payment arrangements • Determine third-party sponsorship needs and process patients according to policy • Examine insurance policies and third-party sponsorship materials for payment sources • Inform attending physicians of patient financial hardship • Update billing systems with patient insurance status • Provide timely customer service to internal customers and assist with departmental coverage • Document authorizations and update referrals in the billing system • Communicate with insurance carriers regarding clinical information, coverage, and payment issues

🎯 Requirements

• High school education-level knowledge of basic grammar and mathematical principles • Some postsecondary education preferred • Additional training or working knowledge of related business • Two to five years of experience working in hospital access, physician office, or billing and collections, or an equivalent combination of relevant education and/or experience • Excellent oral and written communication skills • Ability to analyze data, perform multiple tasks, and work independently • Ability to develop and maintain professional, service-oriented relationships with patients, physicians, co-workers, and supervisors • Ability to understand and comply with policies and procedures • No degrees, licensures, or certifications required