Financial Care Counselor - DRAH Pre-Admission Testing - Raleigh NC

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 Duke’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.

ONSITE POSITION: Monday - Friday (9:00am - 5:30pm)

 

 

Excellent communication skills, oral and written. Ability t oanalyze insurance coverage and benefits for service to ensure timely fi ling. Positionresponsible for high production generated accurately compl etepatient accountsbased on departmental protocol, Greet and provides as sistance to visitors andpatients. Explain policies and collect according to PRMO credit and collectionpolicies. Implement appropriate insurance plan contracts and guidelines.Docume

Excellent communication skills,oral and written. Ability toanalyze insurance coverage and benefits fo rservice to ensure timely filing. Positionresponsible for high productio n generated accurately complete patient accountsbased on departmental pr otocol, Greet and provides assistance to visitors andpatients. Explain p olicies and collect according to PRMO credit and collectionpolicies. Imp lement appropriate insurance plan contracts and guidelines.Document bill ing system Explain bills relationships with patients, businessprocesseso r regulation. Requires working knowledge of collection actions and assis tfinancially responsible persons in arranging payment. Ensure all insura ncerequirements are met prior to patients' arrival and inform patientsof theirfinancial liability prior to arrival for services. Arrange payment options withthe patients and screens patients for government fundingsou rces. Departmentalcoverage as collect cash payments appropriately forall patients. Reconciledaily necessity of third-party sponsorship and proce ss patients in accordancereimbursement. Obtain all Prior Authorization C ertification and/orauthorizations as appropriate. Facilitate paymentsour ces for uninsuredpatients. Determine if patient’s condition is theresult of an accident andperform complete research to determine the appropriat e source ofliability/payment. Admit, register and pre-register patients with accuratepatient demographic and financial data. Resolve insurance c laim rejections/denials.Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy.Perform those duties necessary to entmenta l statistics for budgetary and reporting purposes.Examine insurancsure a ll accounts are processed accuratelyand efficiently. Compile depare poli cies and other third party sponsorshipmaterials forsources of payment. Inform attending physician of patient financial hardship.Completethe man aged care waiver form for patients considered out of networkand receivin g services at a reduced benefit level. Update the billing systemtoreflec t the insurance status of the patient. Refer patients to the Manufacture rDrug program as needed for procedures, and resolves problems. Gathers n ecessarydocumentation to support proper handling of inquiries and compla ints. Assist withaccording to policy and procedure. Enter and update ref errals as required.Communicate with insurance carrier’s regarding clinic al information requestedand to resolve issues relating to coverage and p hysicians, co-workers andsupervisors. Data,perform multiple tasks and wo rk independently. Must be ableto develop and maintain professional, serv ice-oriented must be able tounderstand and comply with policiesand proce dures. Compliance principles. Joballows the opportunity to work independ ently.

Explain bills relationships with patients, businessprocesse s or regulation. Requires working knowledge of collection actions and as sistfinancially responsible persons in arranging payment. Ensure all ins urancerequirements are met prior to patients' arrival and inform patient s of theirfinancial liability prior to arrival for services. Arrange pay ment options withthe patients and screens patients for government fundin g sources. Departmentalcoverage as collect cash payments appropriately f or all patients. Reconciledailynecessity of third-party sponsorship and process patients in accordancereimbursement. Obtain all PriorAuthorizat ion Certification and/orauthorizations as appropriate. Facilitate paymen t sources for uninsuredpatients. Determine if patient’s condition is the result of an accident