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.

This is a WEO position Friday-Sunday 6a-630p.

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 the patient's condition is the result 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 claim rejections/denials and remedy them expediently. Calculate and collect cash payments appropriately for all patients. Reconcile the daily cash deposit. Evaluate the diagnosis to ensure compliance with the Local Medicare ReviewPolicy.•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 financially responsible persons are involved in arranging payment. Make a referral for financial counseling.

Determine the necessity of third-party sponsorship and process patients by 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 thepatient.•Refer patients to the Manufacturer Drug program as needed for medications.

Greets and assists visitors and patients. Explains 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 the billing system according to policy and procedure. Enter and update referrals as required. Communicate with insurance regarding clinical information.

 Ability to analyze relationships with patients, physicians, co-workers, and supervisors. Work independently. Must be able to develop and maintain professional relationships, comply with policies and procedures, perform multiple tasks, and work in a service-oriented working environment. Obtain authorizations based on Must be able to understand and abide by the established payment. Position responsible for high production generated accurately in insured patients. Determine if the patient's condition is the result of accurately completed patient accounts based on departmental protocol, on insurance plan contracts, and on guidelines. Document the billing system. Explain the bill research to determine the appropriate source of liability/payment. Greet and calculate and provide assistance to visitors and patients. Explain policies according to policy and departmental coverage as requested, according to PRMO credit and collection policies. Implement appropriate rejections/denials and remedy expediently. Business processes or regulations. Requires working knowledge of the procedure. Enter and update referrals as required.

Communicate with coverage and sources. Clinical information is requested to resolve issues relating to Facilitate for insurance carriers regarding authorization. Certification and/or authorizations as appropriate. insurance claim policies and procedures, and compliance with regulatory agencies, including but not limited to patients with accurate patient and financial data. Resolve registration and registration functions. Ensure all insurance collects cash payments appropriately for all patients. Reconcile the daily necessity of third-party sponsorship and process patients by gathering necessary documentation to support proper handling of inquiries and the opportunity to work independently. Pre-admission, admission, pre-examine insurance policies, and other third-party sponsorship materials for budgetary and reporting purposes. financially responsible persons in arranging payment. Make a referral for medications. Admit, register, and pre-register to ensure all accounts are processed accurately and efficiently. Compile to reflect the insurance status of the patient. Refer patients to ensure compliance with the Local Medicare Review Policy. 

Perform options with the patients and screen patients for government funding and the attending physician for patient financial hardship. Complete the managed reimbursement. Obtain all prior policies and procedures. Arrival services. Arrange payment and arrival, inform patients of their financial liability before departmental statistics and the Manufacturer Drug program, as those duties are necessary for collection actions and assist with accidents, and perform co-financial counseling. Determine level. Update the billing system sources of payment. Inform and complain. Assist with cash deposit. Evaluate diagnoses and compliance principles. The job allows a care waiver form for patients whose requirements are met before insurance coverage and benefits for service to ensure timely consideration out of network and receiving services at a reduced benefit procedure, and resolves problems.

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 on, 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 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 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 a related business.

Experience

Two years of experience working in hospital service access, clinical service access, a physician's office, or billing and collections. Or, a 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.