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.

 

 

 

 

 

Occupational Summary

 

Hours: 10:00 am-10:30 pm

Weekend shift differential offered. 

 

• Accurately complete patient accounts based on departmental protocol, policies, and procedures, and compliance with regulatory agencies, to include but not be limited to pre-admission, admission, pre-registration, and registration functions.
• Ensure all insurance requirements are met before patients' arrival and inform patients of their financial liability before arrival for services.
• Arrange payment options with the patients and screen patients for government funding sources.
   
  Work Performed

• Analyze insurance coverage and benefits for service to ensure timeliness.
• Obtain authorizations for insurance-based payment on 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 appropriate cash collection for all patients.
• Reconcile the daily necessity of third-party sponsorship and process patients in accordance with reimbursement. 
• Obtain all prior authorization certifications and/or authorizations as appropriate.
• Facilitate payment sources for uninsured patients.
• Admit, register, and preregister patients with accurate patient demographic and financial data.
• Resolve insurance claim rejections/denials and remedy expeditiously. 
• 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.
• 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 nurse 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. Drug program as needed for medications.
• Greets and explains procedures, and resolves problems.
• Gathers necessary documentation to support 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
   

• Excellent communication skills, oral and written.
• Ability to analyze relationships with patients, physicians, co-workers, and supervisors. Data, perform multiple tasks, and work independently.
• Must be able to develop and maintain professional, service-oriented working
• Must be able to understand and comply with policies and procedures.
   
  Level Characteristics
• Position responsible for high production generated accurately in accordance with established business processes or regulations.
• Requires working knowledge of compliance principles. The job allows for the opportunity to work independently.