Financial Care Counselor - Eye Center Hudson III

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. Duke Eye Center Hudson III – Financial Care Counselor Work hours: Monday – Friday 8:00am-4:30pm Compensation & Benefits DUHS Commitment Bonus Program: $5,000.00 (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 Accurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, 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 prior to arrival for services. Arrange payment options with the patients and screen patients for government funding sources. Analyze insurance coverage and benefits for services to ensure timely payment. Obtain authorizations based on insurance plan contracts and guidelines. Document billing system. Explain bills, provide assistance to visitors and patients. Explain policies and departmental coverage as requested. Calculate and apply PRMO credit and collection policies. Implement appropriate cash collection for all patients. Reconcile the necessity of third‑party sponsorship and process patients in accordance with reimbursement. Obtain all Prior Authorization Certification and/or authorizations as appropriate. Facilitate payment sources for uninsured patients. Determine if a patient’s condition is the result of an accident and research appropriate source of liability/payment. Admit, register and pre‑register patients with accurate demographic and financial data. Resolve insurance claim rejections/denials and remedy expediently. 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 budgetary and reporting purposes. Collect actions and assist financially responsible persons in arranging payment. Make referral for financial counseling. Determine with policy and procedure. Examine insurance policies and other third‑party sponsorship materials for sources of payment. Inform attending physician of patient financial hardship. Complete the managed care waiver form for out‑of‑network patients receiving services at a reduced benefit level. Update the billing system to reflect the insurance status of the patient. Refer patients to the Manufacturer Drug program as needed for medications. Greet patients and resolve problems. Gather 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 resolve coverage issues. Knowledge, Skills and Abilities Excellent communication skills, oral and written. Ability to analyze relationships with patients, physicians, co‑workers and supervisors, perform multiple tasks and work independently. Must be able to develop and maintain professional, service‑oriented working relationships. Must be able to understand and comply with policies and procedures. Minimum Qualifications Education: Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some post‑secondary education preferred. Additional training or working knowledge of related business. Experience: Two years experience working in hospital service access, clinical service access, physician office or billing and collections; or an Associate’s degree in a health‑care 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. Equal Opportunity Employer 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. 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 provisions for requests for reasonable accommodation will be provided by each hiring department. #J-18808-Ljbffr