Service Access Nurse - Oncology Durham, NC

About Duke University Hospital

Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States. The largest of the four Duke Health hospitals with 1,062 patient beds, it features comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.

• Duke University Health System is designated as a Magnet organization
• Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses
• Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification
• Duke University Health System has 6,000+ registered nurses
• Quality of Life:
  Living in the Triangle
• Relocation Assistance (based on eligibility)

Manage patient intake process (including patient triage and admissions) for non‑critical transfer patients into Duke University Health System from referring hospitals, clinics, and physicians’ offices, ensuring appropriate level of care and financial screening.

• Evaluate appropriate level of patient care, utilizing expert level clinical decision making to determine severity of illness for all elective, urgent and emergent admissions.
• Coordinate with patient, physicians, nursing and/or clinical staff when requirements of admission are not met/authorized, facilitating alternative care arrangements, physician/administrative override, or delay in service.
• Collect accurate and viable patient insurance information, and escalating all self‑pay patients through the appropriate financial screening process (POMC, Medicaid, Charity Care, patient liability).
• Initiate and facilitate pre‑admission and pre‑certification authorizations, requiring detailed evaluation of clinical documentation.
• Ensure scheduled surgical cases are reconciled with the appropriate billing system and that inpatient vs. outpatient scheduling criteria are met in accordance with published payer CPT lists.
• Enter detailed documentation of actions and outcomes in applicable billing system.
• Provide quality assurance reviews of pre‑registration staff work, ensuring internal controls are met.
• Conduct denial appeal follow‑up, analyzing clinical documentation to support level of care provided and secure reimbursement.
• Act as liaison to all hospital and PDC departments and their staff members, including physicians, clinical nurses, patient resource managers, clinic staff and bed control, as well as patient service representatives, billers, collectors, external case managers, social workers, and discharge planners.

Excellent communication skills (written and verbal), excellent customer service skills including phone etiquette, ability to establish good working relationships with associate departments, and working knowledge of ICD‑9/CPT‑4 coding.

• BSN required.
• 3 years of nursing experience.
• R.N. licensure and North Carolina state licensure 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.

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.