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

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 The Patient Revenue Management Organization 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. Duke Raleigh Outpatient Service Access (Float Position) Financial Care Counselor Work hours: Hours of availability; 10:00 am to 9:00 pm, 8 hr shift depending on location. DUHS Commitment Bonus Program $5,000.00 (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. Department: Duke University Health System – Patient Revenue Management Office (PRMO) We seek to hire a Financial Care Counselor who will embrace our mission of Advancing Health Together. Job Responsibilities Accurately complete patient accounts based on departmental protocol, policies, procedures, and regulatory compliance, including pre‑admission, admission, pre‑registration, and registration functions. Ensure all insurance requirements are met prior to patients' arrival and inform patients of their financial liability before arriving for services. Arrange payment options with patients and screen patients for government funding sources. Analyze insurance coverage and benefits for services to ensure timely reimbursement. Obtain authorizations based on payment plans, insurance plan contracts, and guidelines. Document billing information in the billing system. 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 from all patients. Reconcile daily third‑party sponsorships and process patients in accordance with reimbursement. Obtain all Prior Authorization Certification 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 the appropriate source of liability/payment. Admit, register, and pre‑register patients with accurate demographic and financial data. Resolve insurance claim rejections/denials and remedy issues expediently. Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy. Perform all 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 and collection actions. Make referrals for financial counseling. Determine patient situations according to policy and procedure. Examine insurance policies and third‑party sponsorship materials for payment sources. Inform attending physicians of patient financial hardship. Complete the managed care waiver form for out‑of‑network patients receiving services at a reduced benefit level. Update the billing system to reflect patients' insurance status. Refer patients to the Manufacturer Drug program as needed for medications. Greet patients and resolve problems. Gather necessary documentation to support inquiries and complaints. Assist according to policy and procedure. Enter and update referral information as required. Communicate with insurance carriers regarding clinical information requested and resolve coverage issues. Knowledge, Skills, and Abilities Excellent communication skills, oral and written. Ability to analyze relationships with patients, physicians, co‑workers, and supervisors, and perform multiple tasks independently. Ability 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 independent work. Minimum Qualifications Education 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 is advantageous. 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. Equal 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. 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. #J-18808-Ljbffr Duke University Health System