Financial Care Counselor - DUH ED

Financial Care Counselor - DUH ED

Job at Duke University Health System.

At Duke Health, we are committed to compassionate care that changes the lives of patients, their loved ones, and the greater community. The Financial Care Counselor works within the Patient Revenue Management Organization (PRMO) to support the entire health system in streamlining the revenue cycle, including scheduling, registration, coding, billing, and related functions.

4 days/10‑hour shifts:
Monday‑Wednesday 10:30 am – 9:00 pm;
Thursday 9:00 am – 7:30 pm.

• DUHS Commitment Bonus Program – $5,000 paid in two installments over 12 months (6‑month increments). Only new hires who have not worked for Duke University in the past 12 months are eligible.

• Accurately complete patient accounts based on departmental protocol, policies, and procedures.
• Ensure all insurance requirements are met prior to patient arrival and inform patients of financial liability.
• Arrange payment options with patients and screen for government funding sources.
• Analyze insurance coverage and benefits to ensure timely service.
• Obtain authorizations based on payment and insurance plan contracts.
• Document billing system entries and explain bills to visitors and patients.
• Explain policies and coverage as requested.
• Calculate collections according to PRMO credit and collection policies.
• Collect cash payments from all patients.
• Reconcile third‑party sponsor ships and process patients accordingly.
• Obtain all prior authorization certifications as appropriate.
• Facilitate payment for uninsured patients.
• Determine liability for accident‑related conditions and perform research to find the appropriate 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 Local Medicare Review Policy.
• Perform duties that ensure all accounts are processed accurately and efficiently.
• Compile departmental statistics for budgeting and reporting.
• Assist financially responsible persons in arranging payment.
• Make referrals for financial counseling.
• Determine appropriate actions as per policy and procedure.
• Examine insurance policies and third‑party sponsorship materials for payment sources.
• Inform attending physicians of patient financial hardship.
• Complete managed‑care waiver forms for out‑of‑network patients receiving reduced benefit services.
• Update billing system to reflect patient insurance status.
• Refer patients to manufacturer drug programs as needed.
• Greet patients and resolve related problems.
• Gather documentation to support inquiry and complaint handling.
• Assist with procedures as directed by policy and procedure.
• Enter and update referrals as required.
• Communicate with insurance carriers to resolve coverage issues.

• Excellent oral and written communication skills.
• Ability to analyze relationships with patients, physicians, coworkers, and supervisors.
• Strong multi‑tasking skills with the ability to work independently.
• Understanding and compliance with policies and procedures.

• High production with accurate results under established business processes and regulations.
• Knowledge of compliance principles; ability to work independently.

• Education
  :
  High‑school‑level grammar and mathematics knowledge; post‑secondary education preferred.
• Experience
  :
  Two years in hospital service access, clinical service access, physician office, or billing and collections; or an Associate’s degree with one year of public‑facing experience; or a Bachelor’s degree with one year of public‑facing experience.
• Degrees, Licensures, Certifications
  :
  None required.

Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to 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.

Certain jobs at Duke University and Duke University Health System may require specific physical and/or mental abilities. Additional information and accommodation requests are provided by each hiring department.

Entry level

Full‑time

Finance and Sales

Hospitals and Health Care