Financial Care Counselor - Pyschiatry

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. Join us and discover how we can advance health together. Patient Revenue Management Organization 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. Duke Psychiatry – Financial Care Counselor Work hours: Monday – Friday 8:30 am – 5:00 pm. This is an onsite position only with no weekend requirements. 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. Responsibilities Analyze insurance coverage and benefits for services to ensure timely processing. Obtain authorizations based on payment on insurance plan contracts and guidelines. Document billing system records. Explain bills and provide assistance to visitors and patients. Explain policies and departmental coverage as requested. Calculate and manage PRMO credit and collection policies. Implement appropriate cash collection actions for all patients. Reconcile daily third‑party sponsorships and process patients in accordance with reimbursement. Obtain all Prior Authorization certifications and authorizations as appropriate. Facilitate payment sources for uninsured patients. Determine if a patient’s condition is the result of an accident and perform research to determine the appropriate source of liability/payments. Admit, register and pre‑register patients with accurate demographic and financial data. Resolve insurance claim rejections and 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 referrals for financial counseling. Determine tasks with policy and procedure. Examine insurance policies and other third‑party sponsorship materials for sources of payment. 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 the billing system to reflect the insurance status of the patient. Refer patients to the Manufacturer Drug program as needed. Greet and resolve problems with procedures. 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 to resolve coverage problems. Knowledge, Skills, and Abilities Excellent oral and written communication skills. 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 understand and comply with policies and procedures. Level Characteristics Position responsible for high production generated accurately in accordance with established business processes or regulations. Requires working knowledge of compliance principles. Job allows the opportunity to work independently. Minimum Qualifications Education Basic grammar and mathematical principles normally required through high school; some post‑secondary education preferred. Additional training or knowledge of related business subjects is a plus. Experience Two years of experience working 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. 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 accommodations for reasonable requests will be provided by each hiring department. #J-18808-Ljbffr Duke University Health System