Financial Care Counselor- Duke Primary Care Engagement Center

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 Primary Care

Pursue your passion for caring with Duke Primary Care, which offers family, adolescent, and internal medicine services as well as urgent, general pediatric, and virtual care at nearly 50 clinic locations across central North Carolina.

Financial Care Counselor (FCC) - Duke Primary Care Referrals

**$5,000 commitment Bonus for Eligible Candidates**

The Duke Primary Care Patient Engagement Center (DPC PEC) is a high-volume support center that plays a critical role in the financial coordination of care across the Duke Primary Care network. In addition to handling thousands of patient calls daily, the center provides assistance with insurance verification, cost transparency, payment options, and access to financial assistance programs. By prioritizing clear communication and financial clarity, the PEC helps ensure patients are informed and supported in managing the cost of their healthcare.

Location: 14 Moore Drive Research Triangle Park, NC 27709

Hours: 8am – 5pm  

What you will do:

As a Financial Care Counselor, you will be responsible for accurately managing patient accounts in accordance with departmental protocols, policies, procedures, and regulatory guidelines. This includes handling pre-admission, admission, pre-registration, and registration processes.

You will ensure all insurance requirements are met prior to the patient's arrival and clearly communicate financial responsibilities to patients in advance of services. Additional responsibilities include arranging payment options, assisting patients in understanding their coverage, and screening for eligibility in government funding programs.

• Analyze insurance coverage and benefits for service to ensure timely reimbursement.
• Obtain all Prior Authorization Certification and/or authorizations as appropriate.
• Facilitate payment sources for uninsured patients.
• Determine if patient's condition is the result of an accident and perform complete research to determine the appropriate source of liability/payment.
• Admit, register and pre-register patients with accurate patient demographic and financial data.
• Resolve insurance claim rejections/denials and remedy expediently.
• Calculate and collect cash payments appropriately for all patients.
• Reconcile daily cash deposit. Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy.
• Perform those duties necessary to ensure all accounts are processed accurately and efficiently.
• Compile departmental statistics for budgetary and reporting purposes.
• Explain bills according to PRMO credit and collection policies.
• Implement appropriate collection actions and assist financially responsible persons in arranging payment.
• Make referral for financial counseling.
• Determine necessity of third party sponsorship and process patients in accordance with policy and procedure.
• Examine insurance policies and other third party sponsorship materials for sources of payment.
• Inform attending physician of patient 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 Drug program as needed for medications.
• Greet and provides assistance to visitors and patients.
• Explain policies and procedures, and resolves problems.
• Gathers necessary documentation to support proper handling of inquiries and complaints.
• Assist with departmental coverage as requested.
• Obtain authorizations based on insurance plan contracts and guidelines.
• Document billing system 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 payment.

What you will need:

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, Licensure, and/or Certification

• N/A

Knowledge, Skills, and Abilities

• Excellent communication skills, oral and written.
• Ability to analyze data, perform multiple tasks and work independently.
• Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers and supervisors.
• Must be able to understand and comply with policies and procedures.

Distinguishing Characteristics of this Level

• Position responsible for high production generated accurately in accordance with established business processes or regulation.
• Requires working knowledge of compliance principles.
• Job allows the opportunity to work independently.

The intent of this job description is to provide a representative and level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.

Job Title: FINANCIAL CARE COUNSELOR

Job Code: 4500

FLSA: N

Job Level: C1

Revised Date: 06/27/2005

Supervisory Responsibility: No

Duke University 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, (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.