Duke Clinical Research Institute
Financial Care Counselor - DUHS ASC and Periop
Duke Clinical Research Institute, 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 supporting the entire health system in streamlining revenue functions, including scheduling, registration, coding, and billing.
Duke University Hospital ASC and Periop Work hours: *** 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 are eligible for the bonus.
Position Overview Duke University Health System - Patient Revenue Management Office (PRMO) seeks to hire a
Financial Care Counselor
to support our mission of Advancing Health Together.
Key Responsibilities
Analyze insurance coverage and benefits to ensure timely service.
Obtain authorizations based on insurance contracts and guidelines.
Document billing system activities.
Assist visitors and patients with billing questions.
Explain policies and departmental coverage as requested.
Calculate and process payments according to PRMO policies.
Implement cash collection procedures for all patients.
Reconcile third-party sponsorships and process reimbursements.
Obtain necessary prior authorizations and certifications.
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.
Perform duties to ensure accurate and efficient account processing.
Compile departmental statistics for budgeting and reporting.
Assist with collection actions and payment arrangements.
Refer patients 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 services.
Update billing systems to reflect insurance status.
Refer patients to medication programs as needed.
Greet and assist patients, resolving inquiries and problems.
Gather documentation to support inquiries and complaints.
Enter and update referrals as required.
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 production accuracy according to business processes and regulations.
Requires working knowledge of compliance principles and ability to work independently.
Minimum Qualifications Education High school education required; postsecondary education preferred. Additional training or related work experience is advantageous.
Experience Two years of experience in hospital service access, billing, or collections, or an Associate's/Bachelor's degree with related experience.
Degrees, Licensures, Certifications None required.
Duke is an Affirmative Action/Equal Opportunity Employer committed to diversity and inclusion. We strive to create a community built on collaboration, innovation, and respect, where all voices are heard and contributions respected.
Essential physical job functions may apply; accommodations will be provided upon request.
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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 supporting the entire health system in streamlining revenue functions, including scheduling, registration, coding, and billing.
Duke University Hospital ASC and Periop Work hours: *** 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 are eligible for the bonus.
Position Overview Duke University Health System - Patient Revenue Management Office (PRMO) seeks to hire a
Financial Care Counselor
to support our mission of Advancing Health Together.
Key Responsibilities
Analyze insurance coverage and benefits to ensure timely service.
Obtain authorizations based on insurance contracts and guidelines.
Document billing system activities.
Assist visitors and patients with billing questions.
Explain policies and departmental coverage as requested.
Calculate and process payments according to PRMO policies.
Implement cash collection procedures for all patients.
Reconcile third-party sponsorships and process reimbursements.
Obtain necessary prior authorizations and certifications.
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.
Perform duties to ensure accurate and efficient account processing.
Compile departmental statistics for budgeting and reporting.
Assist with collection actions and payment arrangements.
Refer patients 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 services.
Update billing systems to reflect insurance status.
Refer patients to medication programs as needed.
Greet and assist patients, resolving inquiries and problems.
Gather documentation to support inquiries and complaints.
Enter and update referrals as required.
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 production accuracy according to business processes and regulations.
Requires working knowledge of compliance principles and ability to work independently.
Minimum Qualifications Education High school education required; postsecondary education preferred. Additional training or related work experience is advantageous.
Experience Two years of experience in hospital service access, billing, or collections, or an Associate's/Bachelor's degree with related experience.
Degrees, Licensures, Certifications None required.
Duke is an Affirmative Action/Equal Opportunity Employer committed to diversity and inclusion. We strive to create a community built on collaboration, innovation, and respect, where all voices are heard and contributions respected.
Essential physical job functions may apply; accommodations will be provided upon request.
#J-18808-Ljbffr