Duke Clinical Research Institute
Financial Care Counselor - DRH ED
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 the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.
Duke Regional ED
Financial Care Counselor
Work hours:
Monday-Wednesday 9:00pm - 7:30am and Thursday 8:30pm - 7:00am *** 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 regulatory compliance, 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, arrange payment options, and screen 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 cash collections appropriately for all patients. Reconcile third-party sponsorships and process reimbursements. Obtain all necessary prior authorization certifications and authorizations. Facilitate payment sources for uninsured patients. Determine if a patient's condition is the result of an accident and research liability/payment sources. Admit, 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 in collections and help financially responsible persons arrange payments. 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 insurance status. Refer patients to manufacturer drug programs as needed. Greet and assist patients, resolve problems, and gather documentation for inquiries and complaints. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information requests 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, and 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 working knowledge of compliance principles and the ability to work independently. MINIMUM QUALIFICATIONS Education Knowledge of basic grammar and math, typically acquired through high school education; some postsecondary education preferred. Additional training or relevant experience is beneficial. 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 with one year of experience working with the public; or a Bachelor's degree with one year of experience working with the public. Degrees, Licensures, Certifications None required Duke is an Equal Opportunity Employer committed to diversity and inclusion. We value the contributions of all individuals and foster a community built on collaboration, innovation, and respect. Essential Physical Job Functions: Specific physical and mental abilities may be required depending on the role, with accommodations available upon request.
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Monday-Wednesday 9:00pm - 7:30am and Thursday 8:30pm - 7:00am *** 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 regulatory compliance, 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, arrange payment options, and screen 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 cash collections appropriately for all patients. Reconcile third-party sponsorships and process reimbursements. Obtain all necessary prior authorization certifications and authorizations. Facilitate payment sources for uninsured patients. Determine if a patient's condition is the result of an accident and research liability/payment sources. Admit, 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 in collections and help financially responsible persons arrange payments. 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 insurance status. Refer patients to manufacturer drug programs as needed. Greet and assist patients, resolve problems, and gather documentation for inquiries and complaints. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information requests 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, and 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 working knowledge of compliance principles and the ability to work independently. MINIMUM QUALIFICATIONS Education Knowledge of basic grammar and math, typically acquired through high school education; some postsecondary education preferred. Additional training or relevant experience is beneficial. 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 with one year of experience working with the public; or a Bachelor's degree with one year of experience working with the public. Degrees, Licensures, Certifications None required Duke is an Equal Opportunity Employer committed to diversity and inclusion. We value the contributions of all individuals and foster a community built on collaboration, innovation, and respect. Essential Physical Job Functions: Specific physical and mental abilities may be required depending on the role, with accommodations available upon request.
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