Financial Care Counselor- Duke Lake Norman Emergency Department PRN

Job Summary Accurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies. Perform pre-admission, admission, pre-registration, and registration functions. Ensure all insurance requirements are met before patients’ arrival and inform patients of their financial liability. Arrange payment options and screen for government funding sources. Hours PRN shifts, primarily 7 p.m.–7 a.m. or 11 a.m.–11 p.m. Work Performed Analyze insurance coverage and benefits for service to ensure timely reimbursement. Obtain Prior Authorization Certification and/or authorizations as appropriate. Facilitate payment sources for uninsured patients. Determine if patient's condition is the result of an accident and perform research to identify liability/payment source. Admit, register, and pre-register patients with accurate demographic and financial data. Resolve insurance claim rejections/denials and remedy expediently. Calculate and collect cash payments appropriately for all patients and reconcile daily cash deposits. Evaluate diagnoses for compliance with Local Medicare Review Policy. Ensure all accounts are processed accurately and efficiently. Compile departmental statistics for budgetary and reporting purposes. Explain bills according to PRMO credit and collection policies, implement collection actions and assist financially responsible persons. Make referrals for financial counseling and determine necessity of third‑party sponsorship. Examine insurance policies and third‑party sponsorship materials for payment sources. Inform attending physician of patient financial hardship. Complete managed care waiver forms for out‑of‑network patients receiving reduced benefit services. Update billing system to reflect insurance status. Refer patients to the Manufacturer Drug program as needed. Greet and provide assistance to visitors and patients; explain policies and procedures, and resolve problems. Gather documentation to support inquiries and complaints. Assist with departmental coverage as requested. Obtain authorizations based on insurance plan contracts and guidelines. Document billing system usage per policy and procedure. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information and resolve insurance coverage and payment issues. Knowledge, Skills, and Abilities Excellent oral and written communication skills. 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. Comprehension and compliance 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 and the opportunity to work independently. Minimum Qualifications Education High school education with basic grammar and mathematical principles; some postsecondary education preferred. Additional training or working knowledge of related business. Experience Two years 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 with the public. Or a Bachelor’s degree and one year of experience 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 Duke University Health System