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.

Occ Summary

Accurately complete patient accounts based on collection policies. Implement appropriate collection actions and assist financially responsible persons in arranging payment. Make a referral for financial and reporting purposes. Explain bills according to PRMO credit and collect patients following the policy and procedure. Examine insurance policies and other third-party sponsorship materials for sources of payment for counseling. Determine the necessity of third-party sponsorship and policy. Perform those duties necessary to ensure all accounts are processed for certification and/or authorizations as appropriate. Facilitate payment sources for uninsured patients. Determine if the patient's condition is the reason for the claim rejections/denials and remedy it expediently. Calculate and collect the cost of an accident, and perform complete research to determine the appropriate source of liability/payment. Admit, register, and preregister patients with accurate patient demographic and financial data. Resolve insurance departmental protocol, policies, and procedures, and compliance with regulations for patients, and screen patients for government funding sources.

Work Performed

Analyze insurance coverage and benefits for agencies, to include but not be limited to pre-admission, admission, pre-registration, and registration functions. Ensure all insurance requires maintaining authorizations 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 authorization for visitors and patients. Explain policies and procedures, and resolve specific information requested and issues relating to coverage and services at a reduced benefit level. Update the billing system to reflect the new flument billing system according to policy and procedure. Enter and update referrals 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 MA care waiver form for patients considered out of network and receive knowledge of compliance principles. A job allows the opportunity to work on multiple tasks and work independently. Must be able to develop and maintain payment.

Knowledge, Skills, and Abilities

Excellent communication skills, oral and written. Ability to analyze data and performance with established business processes or regulations. Requires working knowledge of policies and procedures.

Level Characteristics

The position is responsible for high production generated accurately by payments, appropriately for all patients. Reconcile the daily cash deposit. Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy independently.

ect the insurance status of the patient. Refer patients to the manufacturer's professional, service-oriented working relationships with patients, and physical liability prior to arrival for services. Arrange payment options with physicians, co-workers, and supervisors. Must be able to understand and complete them prior to patients' arrival and inform patients of their financer. Drug program as needed for medications. Greet and assist.

Minimum Qualifications

Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy-related conditions), sexual orientation, or military status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

Education

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

Experience

Two years of 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, Licensures, Certifications

None required

Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends onthe robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.