Direct Jobs
Financial Care Counselor - DRAH Midtown
Direct Jobs, Raleigh, North Carolina, United States, 27601
Overview
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 Raleigh Midtown Financial Care Counselor Location:
5920 Sandy Forks Rd, Ste200, Raleigh, NC 27609 Work hours:
Monday - Friday 6:30a - 5:30p; Main shift hours: 8:00am - 4:30pm, 8:30am - 5:00pm or 9:00am - 5:30pm 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. Accurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to 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 prior to arrival for services. Arrange payment options with the patients and screen patients for government funding sources. Work Performed Analyze insurance coverage and benefits for service to ensure timely processing. Obtain authorizations based on insurance plan contracts and guidelines. Document billing system. Explain bills and provide assistance to visitors and patients. Explain policies and departmental coverage as requested. Calculate and apply payments according to PRMO credit and collection policies. Implement appropriate cash collection practices for all patients. Reconcile daily third-party sponsorship requirements 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 patient’s condition is the result of an accident and perform complete research to determine the appropriate source of liability/payment. Admit, register and pre-register patients with accurate patient demographic and financial data. Resolve insurance claim rejections/denials and remedy 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. Coordinate collection actions and assist financially responsible persons in arranging payment. Make referrals for financial counseling. Determine with policy and procedure. Examine insurance policies and other third party sponsorship materials for sources of payment. Inform attending physician 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 and assist with procedures, and resolve problems. Gather necessary documentation to support proper handling of inquiries and complaints. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage. Knowledge, Skills and Abilities Excellent communication skills, oral and written. Ability to analyze relationships with patients, physicians, co-workers and supervisors; data handling, multitasking and independent work. Ability to develop and maintain professional, service-oriented working relationships. Ability 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 postsecondary 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 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. 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.
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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 Raleigh Midtown Financial Care Counselor Location:
5920 Sandy Forks Rd, Ste200, Raleigh, NC 27609 Work hours:
Monday - Friday 6:30a - 5:30p; Main shift hours: 8:00am - 4:30pm, 8:30am - 5:00pm or 9:00am - 5:30pm 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. Accurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to 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 prior to arrival for services. Arrange payment options with the patients and screen patients for government funding sources. Work Performed Analyze insurance coverage and benefits for service to ensure timely processing. Obtain authorizations based on insurance plan contracts and guidelines. Document billing system. Explain bills and provide assistance to visitors and patients. Explain policies and departmental coverage as requested. Calculate and apply payments according to PRMO credit and collection policies. Implement appropriate cash collection practices for all patients. Reconcile daily third-party sponsorship requirements 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 patient’s condition is the result of an accident and perform complete research to determine the appropriate source of liability/payment. Admit, register and pre-register patients with accurate patient demographic and financial data. Resolve insurance claim rejections/denials and remedy 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. Coordinate collection actions and assist financially responsible persons in arranging payment. Make referrals for financial counseling. Determine with policy and procedure. Examine insurance policies and other third party sponsorship materials for sources of payment. Inform attending physician 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 and assist with procedures, and resolve problems. Gather necessary documentation to support proper handling of inquiries and complaints. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage. Knowledge, Skills and Abilities Excellent communication skills, oral and written. Ability to analyze relationships with patients, physicians, co-workers and supervisors; data handling, multitasking and independent work. Ability to develop and maintain professional, service-oriented working relationships. Ability 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 postsecondary 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 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. 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.
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