Financial Care Counselor (Commitment Bonus Eligible)

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.

***$5000.00 Commitment Bonus (2 installments over 12 months in 6-month increments)

* Only new hires who have not worked for Duke University in the past 12 months (at the time of offer) are eligible to receive the sign-on bonus.

 

Shift hours M-F 10 a.m.–630 p.m.

Occ Summary  

Accurately complete patient accounts based on dependencies. Necessity of third-party sponsorship and processing of patients by departmental protocol, policies, and procedures, and compliance with regulatory agencies, including but not limited to pre-admission, admission, pre-registration, and registration functions. Ensure all insurance requirements are met before a client's arrival, and inform patients of their financial liability before their arrival for services. Arrange payment options with the patients and screen patients for government funding sources. This position will be held Tuesday through Friday, 10:30 a.m.–9 p.m., on four ten-hour workdays.

 

 

Work Performed

 

 

Analyze insurance coverage and benefits for service to ensure timely reimbursement. Obtain all Prior Authorization Certification and/or authorizations as appropriate. Facilitate payment sources for uninsured patients. Determine i the patient's condition is the result of an accident and perform complete research to determine the appropriate source of liability/payment. Admit, register, and pre-register patients with accurate patient demographic and financial data. Resolve insurance claim rejections/denials and remedy expediently. Calculate and collect cash payments appropriately for all patients. Reconcile daily cash deposit. Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy.

 

Perform those duties necessary to ensure all accounts are processed accurately and efficiently. Compile departmental statistics for budgetary and reporting purposes. Explain bills according to PRMO credit and collection policies. Implement appropriate collection actions and assist financially responsible persons in arranging payment. Make a referral for financial counseling. Determine 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 restate s of the patient. Refer patients to the Manufacturer Drug program reduced benefit level. Update the billing system to reflect the insurance needed for medications. Greet and assist visitors and patients. Explain policies and procedures, and resolves problems. Gathers necessary documentation to support the proper handling of inquiries and complaints. Assist with departmental coverage as requested. Obtain authorizations based on insurance plan contracts and guidelines. Document billing system according to policy and procedure. Enter and update referrals required. Communicate with insurance carriers regarding clinical information requested and resolve issues relating to coverage and payment.

 

Knowledge, Skills, and Abilities

 

 

Excellent communication skills, oral and written. Ability to analyze data, perform multiple tasks, and work independently. Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers, and supervisors. Must be able to understand and comply with policies and procedures.

 

Level Characteristics

 

 

Position responsible for high production generated accurately by established business processes or regulations. Requires working knowledge of compliance principles. The job allows the opportunity to work independently. 

 

 

 

Minimum Qualifications

 

 

Education

Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some postsecondary education preferred. Additional training or working knowledge of related business.

 

Experience

 

Two years experience working in hospital service access, clinical service access, physician office, or billing and collections. Or, an Assoc