Financial Care Counselor - Duke Otolaryngology of South Durham

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. ONSITE POSITION (Monday - Friday: 7:30 AM - 4:00 PM) Job Overview Accurately complete patient accounts based on departmental protocol and regulatory compliance including pre-admission, admission, pre-registration, and registration functions. Ensure all insurance requirements are met prior to patient arrival and inform patients of their financial liability. 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 and other necessary authorizations. Facilitate payment sources for uninsured patients. Determine if a patient’s condition is the result of an accident and research appropriate liability/payment sources. Admit, register, and pre-register patients with accurate demographic and financial data. Resolve insurance claim rejections/denials and remedy them expediently. Calculate and collect cash payments and reconcile daily cash deposits. Evaluate diagnoses for compliance with the Local Medicare Review Policy. Compile departmental statistics for budgetary and reporting purposes. Explain bills according to PRMO credit and collection policies. Implement appropriate collection actions and assist financially responsible parties in arranging payment. Make referrals for financial counseling and third-party sponsorship as needed. 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 out-of-network patients receiving reduced-benefit services. Update the billing system to reflect the current insurance status of patients. Refer patients to the Manufacturer Drug program as needed. Greet and assist visitors and patients, explain policies and procedures, and resolve problems. Gather necessary documentation to support inquiries and complaints. Assist with departmental coverage when requested. Obtain authorizations based on insurance plan contracts and guidelines. Document billing system usage according to policy and procedure. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information and resolve coverage and payment issues. Knowledge, Skills and Abilities Excellent communication skills, oral and written. Ability to analyze data, perform multiple tasks, and work independently. Ability to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers, and supervisors. Ability to understand and comply with policies and procedures. Position responsible for high production generated accurately in accordance with established business processes or regulations. Requires working knowledge of compliance principles. The role allows the opportunity to work independently. Minimum Qualifications Education – Basic high-school education in grammar and mathematical principles is required; some post-secondary education is 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, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military status. #J-18808-Ljbffr Independent Educational Consultants Association