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.

Occ Summary 

 An ability to analyze insurance coverage and benefits to ensure timely service, obtain authorizations in accordance with established positions, and accurately generate high production. Greet and maintain relationships with patients, business processes, or regulations. Requires working knowledge of medications. Working Internal Float for PT/OT. Float within the OT department to 9 clinic locations as needed. Some Saturday coverage required. This position involves a significant amount of front desk PSA duties. Accurately complete patient accounts based on departmental protocols, policies, and procedures, and compliance with regulatory agencies, to include, but not limited to, pre-registration and registration functions. Ensure all insurance requirements are met before patients' arrival and inform patients of their financial liability prior to arrival for services. Arrange payment options with patients and screen them for government funding sources—process payments according to 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 an appropriate collection of cash payments for all patients. Recognized the daily necessity of third-party sponsorship and processes patients in accordance with reimbursement. Obtain all prior authorization certifications and/or authorizations as appropriate. Facilitate payment sources for uninsured patients. Determine if the patient's condition is the result of an accident and perform complete research to determine the proper source of liability/payments—Pre-register patients with accurate patient demographics and financial data. Resolve insurance claim rejections and denials promptly. Cash deposit. Evaluated diagnoses to ensure compliance with the Local Medicare Review Policy. Perform the necessary duties to ensure that all accounts are processed accurately with the persons in charge of arranging payments. 

Make a referral for financial counseling. Collection actions and financial assistance are determined responsibly in accordance with policy and procedure. Examine insurance policies and other third-party sponsorship materials for sources of payment. Inform the attending physician 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's drug program as needed for procedures and resolve any issues that arise. Gathers necessary documentation to support the 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 and physicians, coworkers, and supervisors. Data, perform multiple tasksand work independently. Must be able to develop and maintain professional, service-oriented skills. Must be able to understand and comply with policies and procedures—compliance principles. The job allows for the opportunity to work independently.

Work Hours: 6:45 a.m. to 3:45 p.m. with an hour lunch, Monday through Friday

Minimum Qualifications

Duke is an Equal Opportunity Employer committed to providing employment opportunities 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 founded on collaboration, innovation, creativity, and a sense of 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 se cure and welcome, that the contributions of allindividuals 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 thatrequire specific physicaland/or mental abilities. Each hiring department will provide additional information and provisions for reasonable accommodations.

Education

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

Experience

Two years of experience working in hospital service access, clinical service access, a physician's 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.