Financial Care Counselor-Commitment Bonus

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

 

About Duke Health's Patient Revenue Management Organization

 

Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.

 

Occ Summary 

 An ability to analyze insurance coverage and benefits to ensure timely service, obtain authorizations in accordance with established positions, and accurately generate high production. Greet and maintain relationships with patients, business processes, or regulations. Requires working knowledge of medications. Working Internal Float for PT/OT. Float within the OT department to 9 clinic locations as needed. Some Saturday coverage required. This position involves a significant amount of front desk PSA duties. Accurately complete patient accounts based on departmental protocols, policies, and procedures, and compliance with regulatory agencies, to include, but not limited to, pre-registration and registration functions. Ensure all insurance requirements are met before patients' arrival and inform patients of their financial liability prior to arrival for services. Arrange payment options with patients and screen them for government funding sources—process payments according to insurance plan contracts and guidelines. Document billing system: Explain bills and assist visitors and patients.

Explain policies and departmental coverage as requested. Calculate according to PRMO credit and collection policies. Implement an appropriate collection of cash payments for all patients. Recognized the daily necessity of third-party sponsorship and processes patients in accordance with reimbursement. Obtain all prior authorization certifications and/or authorizations as appropriate. Facilitate payment sources for uninsured patients. Determine if the patient's condition is the result of an accident and perform complete research to determine the proper source of liability/payments—Pre-register patients with accurate patient demographics and financial data. Resolve insurance claim rejections and denials promptly. Cash deposit. Evaluated diagnoses to ensure compliance with the Local Medicare Review Policy. Perform the necessary duties to ensure that all accounts are processed accurately with the persons in charge of arranging payments. 

Make a referral for financial counseling. Collection actions and financial assistance are determined responsibly in accordance with policy and procedure. Examine insurance policies and other third-party sponsorship materials for sources of payment. Inform the attending physician of the patient's financial hardship. Complete the managed care waiver form for patients considered out-of-network and receiving services at a reduced benefit level. Update the billing system to reflect the insurance status of the patient. Refer patients to the manufacturer's drug program as needed for procedures and resolve any issues that arise. Gathers necessary documentation to support the proper handling of inquiries and complaints. Assist according to policy and procedure. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage and physicians, coworkers, and supervisors. Data, perform multiple tasksand work independently. Must be able to develop and maintain professional, service-oriented skills. Must be able to understand and comply with policies and procedures—compliance principles. The job allows for the opportunity to work independently.

 

Work Hours: 6:45 a.m. to 3:45 p.m. with an hour lunch, Monday through Friday

 

 

Minimum Qualifications

 

 

Duke is an Equal Opportunity Employer committed to providing employment opportunities 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.

 

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