Duke University
Financial Care Counselor - DRH Outpatient
Duke University, Durham, North Carolina, United States, 27703
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.
About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's 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.
Duke Regional Outpatient Financial Care Counselor Work hours:
Fridays for 4 hours, Saturdays from 7:00 AM to 3:00 PM, and Sundays from 7:00 AM to 3:00 PM
*** 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.
Position Overview Duke University Health System - Patient Revenue Management Office (PRMO) seeks to hire a
Financial Care Counselor
who will embrace our mission of
Advancing Health Together .
Responsibilities include accurately completing patient accounts based on departmental protocols, policies, procedures, and compliance with regulatory agencies, including pre-admission, admission, pre-registration, and registration functions.
Ensure all insurance requirements are met prior to patient arrival, inform patients of their financial liabilities, and arrange payment options, screening for government funding sources.
Work Performed
Analyze insurance coverage and benefits to ensure timely processing.
Obtain authorizations based on insurance plan contracts and guidelines.
Document billing system activities.
Explain bills and provide assistance to visitors and patients.
Explain policies and departmental coverage as requested.
Calculate and process payments according to PRMO credit and collection policies.
Implement appropriate cash collection procedures.
Reconcile third-party sponsorship and process reimbursements.
Obtain all necessary prior authorization certifications.
Facilitate payment sources for uninsured patients.
Research and determine liability/payment sources for accident-related conditions.
Register and pre-register patients with accurate demographic and financial data.
Resolve insurance claim rejections/denials promptly.
Ensure diagnoses are compliant with Medicare policies.
Perform duties to ensure accurate and efficient account processing.
Compile departmental statistics for budgeting and reporting.
Assist with collection actions and payment arrangements.
Make referrals for financial counseling.
Review insurance policies and third-party sponsorships for payment sources.
Inform physicians of patient financial hardships.
Complete managed care waiver forms for out-of-network patients receiving reduced benefits.
Update billing systems to reflect current insurance status.
Refer patients to medication assistance programs as needed.
Greet and assist patients, resolving issues as necessary.
Gather documentation to support inquiries and complaints.
Assist with policy and procedural adherence.
Enter and update referral information.
Communicate with insurance carriers regarding clinical information and coverage issues.
Knowledge, Skills, and Abilities
Excellent oral and written communication skills.
Ability to analyze relationships with patients, physicians, co-workers, and supervisors; perform multiple tasks; work independently.
Develop and maintain professional, service-oriented working relationships.
Understand and comply with policies and procedures.
Level Characteristics
Responsible for high-volume, accurate production in accordance with business processes and regulations.
Requires knowledge of compliance principles; opportunity to work independently.
Minimum Qualifications Education High school diploma required; postsecondary education preferred. Additional training or related work experience is advantageous.
Experience At least two years in hospital or clinical service access, physician office, or billing and collections. Alternatively, an Associate's degree with one year of relevant experience, or a Bachelor's degree with one year of experience working with the public.
Degrees, Licensures, Certifications None required.
Equal Opportunity Statement Duke is an Equal Opportunity Employer committed to diversity and inclusion. All community members are encouraged to contribute to a respectful and welcoming environment.
Physical Job Functions Some roles may require specific physical and mental abilities. Requests for accommodations will be handled by the hiring department.
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About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's 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.
Duke Regional Outpatient Financial Care Counselor Work hours:
Fridays for 4 hours, Saturdays from 7:00 AM to 3:00 PM, and Sundays from 7:00 AM to 3:00 PM
*** 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.
Position Overview Duke University Health System - Patient Revenue Management Office (PRMO) seeks to hire a
Financial Care Counselor
who will embrace our mission of
Advancing Health Together .
Responsibilities include accurately completing patient accounts based on departmental protocols, policies, procedures, and compliance with regulatory agencies, including pre-admission, admission, pre-registration, and registration functions.
Ensure all insurance requirements are met prior to patient arrival, inform patients of their financial liabilities, and arrange payment options, screening for government funding sources.
Work Performed
Analyze insurance coverage and benefits to ensure timely processing.
Obtain authorizations based on insurance plan contracts and guidelines.
Document billing system activities.
Explain bills and provide assistance to visitors and patients.
Explain policies and departmental coverage as requested.
Calculate and process payments according to PRMO credit and collection policies.
Implement appropriate cash collection procedures.
Reconcile third-party sponsorship and process reimbursements.
Obtain all necessary prior authorization certifications.
Facilitate payment sources for uninsured patients.
Research and determine liability/payment sources for accident-related conditions.
Register and pre-register patients with accurate demographic and financial data.
Resolve insurance claim rejections/denials promptly.
Ensure diagnoses are compliant with Medicare policies.
Perform duties to ensure accurate and efficient account processing.
Compile departmental statistics for budgeting and reporting.
Assist with collection actions and payment arrangements.
Make referrals for financial counseling.
Review insurance policies and third-party sponsorships for payment sources.
Inform physicians of patient financial hardships.
Complete managed care waiver forms for out-of-network patients receiving reduced benefits.
Update billing systems to reflect current insurance status.
Refer patients to medication assistance programs as needed.
Greet and assist patients, resolving issues as necessary.
Gather documentation to support inquiries and complaints.
Assist with policy and procedural adherence.
Enter and update referral information.
Communicate with insurance carriers regarding clinical information and coverage issues.
Knowledge, Skills, and Abilities
Excellent oral and written communication skills.
Ability to analyze relationships with patients, physicians, co-workers, and supervisors; perform multiple tasks; work independently.
Develop and maintain professional, service-oriented working relationships.
Understand and comply with policies and procedures.
Level Characteristics
Responsible for high-volume, accurate production in accordance with business processes and regulations.
Requires knowledge of compliance principles; opportunity to work independently.
Minimum Qualifications Education High school diploma required; postsecondary education preferred. Additional training or related work experience is advantageous.
Experience At least two years in hospital or clinical service access, physician office, or billing and collections. Alternatively, an Associate's degree with one year of relevant experience, or a Bachelor's degree with one year of experience working with the public.
Degrees, Licensures, Certifications None required.
Equal Opportunity Statement Duke is an Equal Opportunity Employer committed to diversity and inclusion. All community members are encouraged to contribute to a respectful and welcoming environment.
Physical Job Functions Some roles may require specific physical and mental abilities. Requests for accommodations will be handled by the hiring department.
#J-18808-Ljbffr