Financial Care Counselor

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

Accurately complete patient accounts based on department policies. Implement appropriate collection actions and assist financially responsible persons in arranging payment. Make referrals for financial and reporting purposes. Explain bills according to PRMO credit and co-pay patients by all account policies and procedures. Examine insurance policies and other third-party sponsorship materials for sources of financial counseling. The necessity of third-party sponsorship and procurement. Perform those duties necessary to ensure allaccounts are processed and/or authorized as appropriate. Facilitate payment sources for uninsured patients. Determine if the patient's condition is the cause of claim rejections/denials and remedy them expediently. Calculate and collect the cost of an accident and perform complete research to determine the appropriate source of liability or payment. Admit, register, and pre-register patients with accurate patient demographic and financial data. Resolve internal protocols, policies, and procedures to ensure compliance with regulatory patients and screen patients; for government funding sources.

 

Work Performed

 

Analyze insurance coverage and benefits for various agencies, including but not limited to pre-admission, admission, pre-registration, and registration functions. Ensure all insurance requires authorization based on insurance plan contracts and guidelines. Docroblems. Gathers necessary documentation to support proper handling of inquiries and complaints. Assist with departmental coverage as requested. Observe to ensure timely reimbursement. Obtain all Prior authorizations for visitors and patients. Explain policies and procedures, and resolve any information requested and issues relating to coverage and services at a reduced benefit level. Update the billing system to reflect the billing system according to policy and procedure. Enter and update the references as required. Communicate with insurance carriers regarding claims accurately and efficiently. Compile departmental statistics for budgetary Inform the attending physician of the patient's financial hardship. Complete the Medicare Caregiver care waiver form for patients considered out of network and receive a copy of the compliance principles. The job allows the opportunity to work on multiple tasks and work independently. Must be able to develop and maintain a plan.

 

Knowledge, Skills, and Abilities

 

Excellent communication skills, oral and written. Ability to analyze data and perform management with established business processes or regulations. It requires working with policies and procedures.

 

Level Characteristics

 

Position responsible for high production generated accurately by payments appropriately for all patients. Reconcile the daily cash deposit. Evaluate diagnoses to ensure compliance with the LocalMedicare Review Policy.

the insurance status of the patient. Refer patients to the manufacturer for professional, service-oriented working relationships with patients and their readiness before arrival for services. Arrange payment options with colleagues, co-workers, and supervisors. Must be able to understand and ensure compliance before patients' arrival and inform patients of their financial Drug program as needed for medications. Greet and provide assistance

 

 

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 Associate's degree in a healthcare-related field and one year of experience working with the public. Or a Bachelor's degree and one year of experience working with the public.

 

Degrees, licenses, and certifications

 

None required

 

Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment