Financial Care Counselor - DRH ED Job Durham area,North Carolina USA,Healthcare

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 supporting the entire health system in streamlining the revenue cycle, including scheduling, registration, coding, billing, and other essential revenue functions.

Duke Regional ED

Financial Care Counselor

Work hours:

Monday-Wednesday 9:00pm - 7:30am and Thursday 8:30pm - 7:00am

*** DUHS Commitment Bonus Program $5000.00 (paid in 2 installments over 12 months - 6 month increments) ***

* Only new hires who have not worked for Duke University in the past 12 months (at the time of offer) are eligible to receive the commitment bonus.

Duke University Health System - Patient Revenue Management Office (PRMO) seeks to hire a Financial Care Counselor who will embrace our mission of "Advancing Health Together."

Responsibilities include accurately completing patient accounts based on departmental protocols, policies, procedures, and regulatory compliance, including pre-admission, admission, pre-registration, and registration functions.

Ensure all insurance requirements are met prior to patients' arrival and inform patients of their financial liability. Arrange payment options and screen patients for government funding sources.

Work Performed

Analyze insurance coverage and benefits to ensure timely processing.

Obtain authorizations based on insurance plan contracts and guidelines.

Document billing system activities.

Explain bills and provide assistance to visitors and patients.

Explain policies and departmental coverage as requested.

Calculate and process payments according to PRMO credit and collection policies.

Implement appropriate cash collection procedures.

Reconcile daily third-party sponsor ships and process reimbursements.

Obtain all necessary Prior Authorization Certifications and approvals.

Facilitate payment sources for uninsured patients.

Research liability/payment sources if the patient's condition results from an accident.

Admit, register, and pre-register patients with accurate demographic and financial data.

Resolve insurance claim rejections/denials promptly.

Evaluate diagnoses for compliance with Medicare policies.

Ensure all accounts are processed efficiently and accurately.

Compile departmental statistics for budgeting and reporting.

Assist with collection actions and payment arrangements.

Make referrals for financial counseling.

Review insurance policies and third-party sponsor ships for payment sources.

Inform physicians of patient financial hardships.

Complete managed care waiver forms for out-of-network patients receiving reduced benefits.

Update billing systems to reflect insurance status.

Refer patients to manufacturer drug programs as needed.

Greet patients, assist with procedures, and resolve issues.

Gather documentation for inquiries and complaints.

Enter and update referrals as required.

Communicate with insurance carriers regarding coverage issues.

Knowledge, Skills, and Abilities

Excellent oral and written communication skills.
Ability to analyze relationships with patients, physicians, co-workers, and supervisors; perform multiple tasks; work independently.
Develop and maintain professional, service-oriented working relationships.
Understand and comply with policies and procedures.

Level Characteristics

Responsible for high-volume, accurate work in accordance with established processes and regulations.
Requires working knowledge of compliance principles and the ability to work independently.

MINIMUM QUALIFICATIONS

Education

High school education with knowledge of basic grammar and math; postsecondary education preferred. Additional training or related work experience is advantageous.

Experience

Two years in hospital service access, clinical service access, physician office, billing, or collections; or an Associate's degree with one year of experience working with the public; or a Bachelor's degree with one year of experience.

Degrees, Licensures, Certifications

None required.

Duke is an Equal Opportunity Employer committed to diversity and inclusion.

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