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Duke University Health System

Financial Care Counselor - DRH Outpatient

Duke University Health System, Durham, North Carolina, United States, 27703

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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 supporting 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. 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 patients' arrival, inform patients of their financial liability beforehand, arrange payment options, and screen for government funding sources. Work Performed

Analyze insurance coverage and benefits to ensure timely processing. Obtain necessary authorizations based on insurance plan contracts and guidelines. Document billing information accurately. Assist visitors and patients by explaining bills and policies. Calculate and process payments according to PRMO policies. Implement cash collection procedures appropriately. Reconcile third-party sponsorships and process reimbursements. Obtain all prior authorization certifications as appropriate. Facilitate payment sources for uninsured patients. Research liability/payment sources if patient's condition results from an accident. Register and pre-register patients with accurate demographic and financial data. Resolve insurance claim rejections/denials promptly. Evaluate diagnoses for compliance with Medicare policies. Ensure all accounts are processed accurately and efficiently. Compile departmental statistics for budgeting and reporting. Assist financially responsible persons with payment arrangements. Refer patients for financial counseling. Review insurance policies and sponsorship materials for payment sources. Inform attending physicians of patient financial hardships. Complete managed care waiver forms for out-of-network patients receiving services at reduced benefits. Update billing systems to reflect insurance status. Refer patients to manufacturer drug programs as needed. Greet patients, handle procedures, and resolve problems efficiently. Gather documentation to support inquiries and complaints. Update referrals as required and communicate with insurance carriers regarding 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 work in accordance with business processes and regulations. Requires working knowledge of compliance principles and the ability to work independently. Minimum Qualifications

Education

High school education required; postsecondary education preferred. Additional training or related work experience is beneficial. Experience

Two years in hospital or clinical service access, physician office, billing, or collections; or an Associate's degree with one year of experience working with the public; or a Bachelor's degree with one year of experience. Degrees, Licensures, Certifications

None required. Duke is an Equal Opportunity Employer committed to diversity and inclusion. We foster a community where all individuals feel secure, respected, and heard. All members are responsible for upholding these values. Essential physical job functions may apply; accommodations are available upon request.

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