Financial Care Counselor - DRAH Outpatient Service Access (Float Position)

Financial Care Counselor - DRAH Outpatient Service Access (Float Position) Work Arrangement: Regular or Temporary: Regular Location: Raleigh, NC 27710 Date: Jul 15, 2026 At Duke Health, we are driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. Join us and discover how we can advance health together. Pursue your passion for caring with the Patient Revenue Management Organization, which is the 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 for Duke Health. Job Summary The Financial Care Counselor will 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. The counselor will ensure all insurance requirements are met prior to patients’ arrival, inform patients of their financial liability, arrange payment options, and screen patients for government funding sources. Responsibilities Analyze insurance coverage and benefits for services to ensure timely payment. Obtain authorizations based on payment 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 apply PRMO credit and collection policies. Collect cash payments appropriately for all patients. Reconcile daily necessity of third‑party sponsorship and process patient reimbursement accordingly. 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 liability/payment sources. Admit, register and pre‑register patients with accurate demographic and financial data. Resolve insurance claim rejections/denials and remedy them expediently. Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy. Perform duties to ensure all accounts are processed accurately and efficiently. Compile departmental statistics for budgetary and reporting purposes. Execute collection actions and assist financially responsible persons in arranging payment. Make referrals for financial counseling. Determine appropriate policy and procedure application. Examine insurance policies and other sponsorship materials for payment sources. Inform attending physicians of patient financial hardship. Complete the managed care waiver form for patients considered out of network and receiving services at a reduced benefit level. Update billing system to reflect the insurance status of the patient. Refer patients to the Manufacturer Drug program as needed for medications. Greet and provide procedures, resolving 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 oral and written communication skills. Ability to analyze relationships with patients, physicians, co‑workers and supervisors; perform multiple tasks independently. Capability to develop and maintain a professional, service‑oriented working environment. Strong understanding of and compliance with policies and procedures. Level Characteristics Position is responsible for high production generated accurately in accordance with established business processes or regulation. Requires working knowledge of compliance principles; job allows opportunity to work independently. Minimum Qualifications Education Basic grammar and mathematical principles normally required through a high school education, with some postsecondary education preferred. Additional training or working knowledge of related business is advantageous. Experience

• Two years of experience 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. 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. Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and related conditions), sexual orientation or military status. Read more about Duke’s commitment to affirmative action and nondiscrimination at hr.duke.edu/eeo. Nearest Major Market: Durham Nearest Secondary Market: Raleigh #J-18808-Ljbffr Duke PF