Financial Care Counselor - Eye Center Hudson III

Financial Care Counselor – Duke 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. 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. Work Hours Monday - Friday 8:00am-4:30pm 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. Work Performed Analyze insurance coverage and benefits for services to ensure timely billing. Obtain authorizations based on insurance plan contracts and guidelines. Document billing system procedures. Explain bills, provide assistance to visitors and patients. Explain policies and departmental coverage as requested. Calculate collections according to PRMO credit and collection policies. Implement appropriate cash payments for all patients. Reconcile daily third‑party sponsorship and process patients in accordance with reimbursement guidelines. Obtain all prior authorization certifications 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 liability/payment sources. Admit, register and pre‑register patients with accurate demographic and financial data. Resolve insurance claim rejections/denials 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. Assist financially responsible persons in arranging payment. Make referral for financial counseling. Determine actions according to 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 for medications. Greet patients and resolve problems. Gather necessary documentation to support proper handling of inquiries and complaints. Assist in accordance with policy and procedure. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information requested and to 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. Level Characteristics Position responsible for high production generated accurately in accordance with established business processes or regulation. Requires working knowledge of compliance principles. Job allows the opportunity to work independently. 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 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. Equal Employment Opportunity Statement 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, it is essential that 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 Duke Clinical Research Institute