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 Primary Care. 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 Dukeâ€™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.
Occ Summary Work Performed-Knowledge, Skills, and Abilities. Perform other related duties incidental to the work described herein. Level Characteristicsprocedures. procedures. The Medical Records Coder II is a certified coder. Coordinate/review work of subordinate employees and assist with the training and continuing education programs. Code medical records utilizing ICD-9-CM and CPT-4 coding conventions. Review the medical record to assure specificity of diagnoses, procedures, and appropriate/optimal reimbursement for hospital and/or professional charges. Abstract information from medical records following established methods and review of the complex (problematic coding that needs research and reference checking) medical records and accurately code the primary/secondary diagnoses and procedures using ICD-9-CMand/or CPT coding conventions.
Coordinate rate/review the work of designated employees. Ensure quality and quantity of work performed through regular audits. Assist with research, development, and presentation of continuing education programs on areas ofspecializat ion. Review medical record documentation and accurately code the primary/secondary diagnoses and procedures using ICD-9-CM and CPT-4 coding conventions. Sequence the diagnoses and procedures using coding guidelines. Ensure DRG/APC assignment is accurate. Abstract and compile data from medical records for appropriate optimal reimbursement for hospital and/or professional charges. Consult with and educate physicians on coding practices and conventions in order to provide detailed coding information. Communicate with nursing and ancillary services personnel for needed documentation for accurate coding. Maintain a thorough understanding of anatomy and physiology, medical terminology, disease processes, and surgical techniques through participation in continuing education programs to effectively apply ICD- 9-CM and CPT-4 coding guidelines to inpatient and outpatient diagnoses and maintain a thorough understanding of medical record practices, standard s, regulations, JointCommission on Accreditation of Health Organizations (JCAHO), HealthCare/Finance Administration(HCFA), Medical Review of North Carolina (MRNC), etc. Assist with special projects as required. Advance d ICD-9-CM & CPT-4 coding conventionsAnatomy and PhysiologyMedical TerminologyExtensive DRG/APC reimbursement knowledge coding software familiarity effective written and verbal communication skills data entry/CRT
Work requires organization, analytical, and communication skills programs. generally acquired through the completion of a Bachelor's degree
Four years of administrative experience to acquire competence in applying compliance, coding, and auditing principles as they relate to insurance billing, collections, consulting, and other revenue cycle-related functions. For technical coding, two of the four years of experience with DRGs and APR-DRG's are required. Experience in formal teaching of coding is preferred. RHIA or RHIT or CCS is required. For professional coding, specialty coding experience in surgical or E/M coding is preferred. CPC or CCS or RHIT or RHIA or CPMA is required.
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