Financial Care Counselor - Duke Health Center of Clayton

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.

 

Duke Health Integrated Practice

 

Duke Health Integrated Practice comprises more than 110 primary and specialty outpatient clinics, extending the reach of Duke Health's mission across the state of North Carolina.

 

$5000 Commitment Bonus for qualifying candidates! 

 

JOB LOCATION

Duke Health Center of Clayton - 95 Springbrook Ave

 

JOB SUMMARY

We are seeking a Financial Care Counselor (FCC) to be an integral part of the patient care team in the clinic/service area and is responsible for the revenue cycle patient access activities related to but not limited to financial counseling and clearance of patients to include service specific authorizations and referrals. The FCC will need to accurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to pre-admission, admission, pre-registration and registration functions. Ensure all insurance requirements are met prior to patients' arrival and inform patients of their financial liability prior to arrival for services. Arrange payment options with the patients and screens patients for government funding sources. 

 

JOB DUTIES AND RESPONSIBILITIES

Patient Identification & Insurance Verification:

• Perform an in-depth review of accounts to review and resolve warnings, alerts and confirmation checks presented; execute appropriate process / corrections / updates (for example MSPQ.)
• Assess the current financial situation of patients through the verification of benefits; serving as the technical expert for reimbursement and the interpretation of benefits to maximize patient coverage.  Maintain proficiency in verifying insurance eligibility and obtain benefits via all methods (e.g., integrated vendor eligibility solutions, phone, fax, or payer website). 
• Contact Risk management / Workman’s Compensation to determine financial liability. Coordinate registration and billing for covered services and update all information in Epic.
• Maintain an understanding of unique patient pricing structures (e.g., retail priced, non-covered) that reduce a patient’s coverage for full benefits and renders them under-insured.  Communicate the financial circumstances to patient and physician as early as possible.  Assist in evaluating a coordinator clinical and financial plan to maximize the patient’s benefit coverage. 

Provide Patient Financial Education & Counseling:

• Answer in depth questions on patient facing forms (for example COA/COT, MSPQ, ABN, and Self-Administered Drugs) to ensure understanding of policies and patient requirements. 
• Assist patients in navigating complex personal financial decisions.  Provide guidance on governmental health insurance regulations and commercial health plan requirements to empower patients with an understanding of financial implications and coverage as it applies to current and future visits. 
• Through conversation with the patient, evaluate patient / guarantor assets and liabilities to determine ability to pay for previous, future, and current services.  Prospectively address patient financial responsibility and identify additional funding opportunities to safeguard patients and Duke.  Examine insurance policies and other third-party sponsorship materials for sources of payment. 
• Completely and accurately, document all patient encounters and financial/insurance outcomes to ensure comprehensive audit trail. 
• Provide financial counseling to patients and their families regarding outstanding patient liability –co pays, deductibles, coinsurance and (self-pay) balances for healthcare services.  With provider involvement, determine urgency of scheduled care for patients with large financial liabilities resulting in either a decision to proceed or a decision to obtain sponsorship. 
• Maintain an in-depth knowledge of Duke’s Financial Assistance and billing policies to provide financial advice to patients and their guarantors.  Evaluate patient requests for financial assistance or other medical assistance programs and refer to appropriate group i