FINANCIAL CARE COUNSELOR

Overview 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. Patient Revenue Management Organization 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. Responsibilities Accurately complete patient accounts based on departmental protocols and regulatory compliance, including pre-admission, admission, pre-registration, and registration. Ensure all insurance requirements are met prior to patient arrival and inform patients of their financial liability prior to services. Arrange payment options with patients and screen patients for government funding sources. Analyze insurance coverage and benefits to ensure timely reimbursement; obtain prior authorization certifications as appropriate. Facilitate payment sources for uninsured patients; determine if the patient’s condition involves an accident and research the appropriate source of liability/payment. Admit, register and preregister patients with accurate demographic and financial data; resolve insurance claim rejections/denials promptly. Calculate and collect cash payments; reconcile daily cash deposits. Evaluate diagnoses for compliance with the Local Medicare Review Policy; compile department statistics for budgetary and reporting purposes. Explain bills according to PRMO credit and collection policies; implement appropriate collection actions and assist financially responsible persons in arranging payment. Make a referral for financial counseling; determine the necessity of third-party sponsorship and process patients accordingly; examine insurance policies and other sponsorship materials for payment sources. Inform the attending physician of patient financial hardship; complete the managed care waiver form for out-of-network services at reduced benefit level; update the billing system to reflect insurance status. Refer patients to the Manufacturer Drug program as needed for medications; greet and assist visitors, explain policies, gather documentation, and assist with department coverage. Obtain authorizations based on insurance plan contracts and guidelines; document the billing system according to policy and procedure; enter and update referrals; communicate with insurance carriers regarding clinical information requested and to resolve coverage and payment issues. Qualifications Excellent communication skills, both oral and written. Ability to analyze data, perform multiple tasks, and work independently. Ability to develop and maintain professional, service-oriented relationships with patients, physicians, co-workers and supervisors. Ability to understand and comply with policies and procedures. Education & Experience Education : Work requires knowledge of 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. 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; or a bachelor’s degree and one year of experience working with the public. Licenses & 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. About Duke 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. Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas — an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values. #J-18808-Ljbffr Direct Jobs