Financial Care Counselor - DRH ED

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. This includes 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.

Accurately complete patient accounts based on departmental protocol, policies, procedures, and compliance with regulatory agencies, including but not limited to 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 before arrival for services. Arrange payment options with the patients and screen patients for government funding sources.

Work Performed

Analyze insurance coverage and benefits for service 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 for all patients.

Reconcile daily third-party sponsor ships and process patients accordingly for reimbursement.

Obtain all Prior Authorization Certifications and/or authorizations as appropriate.

Facilitate payment sources for uninsured patients.

Determine if patient's condition is the result of an accident and perform research to identify the appropriate liability/payment source.

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

Resolve insurance claim rejections/denials promptly.

Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy.

Perform duties necessary to ensure all accounts are processed accurately and efficiently.

Compile departmental statistics for budgeting and reporting.

Assist financially responsible persons in payment arrangements and collection actions.

Make referrals for financial counseling.

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

Inform attending physicians of patient financial hardships.

Complete the managed care waiver form for out-of-network patients receiving services at reduced benefits.

Update billing systems to reflect insurance status.

Refer patients to Manufacturer Drug programs as needed.

Greet patients, handle procedures, and resolve problems.

Gather documentation to support inquiries and complaints.

Assist according to policy and procedure.

Enter and update referrals as required.

Communicate with insurance carriers regarding clinical information requests and 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 knowledge of compliance principles and the ability to work independently.

MINIMUM QUALIFICATIONS Education

Knowled…