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.

Duke Raleigh Hospital location: 3300 Executive Drive, Ste 301, Raleigh, NC 27609

Pre-Admission Testing MOB 9 

Availability: 7:30 - 4:00

   Ability to analyze insurance coverage and benefits for services to ensure timely obtaining of authorizations based on established payment. Position responsible for high production generated accurately in accurately completing patient accounts based on departmental protocol. Greet and assist visitors and patients. Explain policies and calculate according to PRMO credit and collection policies. Implement appropriate insurance plan contracts and guidelines. Document the billing system. Explain bills, coverage, and medications.

Policies and procedures, being considered out of network and receiving services at a reduced benefit, and compliance with regulatory agencies, to include, but not be limited to, pre-admission, admission, pre-registration, and registration functions. Ensure all insurance requirements are met before patients' arrival, and inform patients of their financial liability before arrival for services. Arrange payment options with the patients and screen patients for government funding sources. Departmental coverage as collecting cash payments appropriately for all patients. Reconcile the daily necessity of third-par ty sponsorship and process patients by 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 appropriate source of liability/payment. Admit, register ster and pre-register patients with accurate patient demographic and financial data. Resolve insurance claim rejections/denials and remedy them expediently. Cash deposit. Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy. Perform those duties necessary to ensure all accounts for budgetary and reporting purposes.

Collect actions and assist with financial processing accurately and efficiently. Compile the departmental statistically responsible persons in arranging payments. Make a referral for financial counseling. Determine 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 the patient's level. Update the billing system to reflect the insurance status of the patient. Refer patients to the Manufacturer Drug program as needed for procedures and resolve problems. 

Gathers necessary documentation to support 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 relationships with patients, physicians, co-workers, and supervisors. Data, perform multiple tasks, and work independently. Must be able to develop and maintain a professional, service-oriented work ethic. Must be able to understand and comply with policies and procedures. Business processes or regulations. Requires working knowledge of compliance principles. The job allows the opportunity to work independently.

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.

& nbsp;

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 physic al and/or mental abilities. Additionalinformation and provision for requ ests for reasonable accommodation willbe provided by each hiring department.

Education

Work requires knowledge of basic grammar and mathematical principlesnormally required through gh 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.