Direct Jobs
Financial Care Counselor-Commitment Bonus
Direct Jobs, Durham, North Carolina, United States, 27703
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.
Work Schedule: Friday, Saturday, and Sunday (7:00 am-7:30 pm)
Occ Summary Ability to analyze insurance coverage and benefits for services to ensure timely authorization based on established payment relationships with patients, physicians, co‑workers, and supervisors.
The position is responsible for high production, accurately completing patient accounts according to departmental protocol, greeting and assisting visitors and patients. Explain policies and calculate due amounts according to PRMO credit and collection policies.
Implement appropriate work independently. Must develop and maintain professional relationships and comply with policies and procedures on insurance plan contracts and guidelines. Document billing system understandings, explain bills, business processes, or regulations. Requires working knowledge of uninsured patients and determine the appropriate source of liability/payment based on policy and sources.
Coverage and clinical information are requested to resolve issues relating to facilitating payment sources for authorization, certification, and/or authorizations as appropriate. Compliance with regulatory agencies, including insurance claim departmental policies, and collecting cash payments appropriately for all patients. Reconcile daily and work independently. Ensure accurate patient demographics and financial data. Resolve registration and registration functions. Ensure all insurance arrangements are made and inform patients of their financial liability before discussing options and screening for government funding, pre‑admission, admission, and pre‑requirements before the patients’ arrival for services. Arrange payment reimbursement and obtain all prior authorizations. Perform complete admission, register, preregister, and remedy denials expediently. Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy.
Compile statistics for budgetary and reporting purposes. Collection ensures all accounts are processed accurately and efficiently, and assist financially responsible persons in arranging payment. Make referrals for financial counseling, determine necessity of third‑party sponsorship, and process patients according to policy and procedure. Examine insurance policies and third‑party materials for sources of payment. Inform the attending physician of the patient’s 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. Resolve problems, gather documentation to support proper handling of inquiries and complaints, assist with departmental coverage as requested, enter and update referrals, and communicate with insurance carriers regarding data. Perform multiple tasks and remain service‑oriented. Must understand and comply with principles. The job allows working in an Emergency Department environment.
Minimum Qualifications Duke is an Equal Opportunity Employer committed to providing employment opportunities 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.
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 of experience working in hospital service access, clinical service access, a physician's 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, Licenses, Certifications None required.
Equal Employment Opportunity 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, all members of our community must feel secure and welcome, have their contributions respected, and all voices heard. All members of our community have a responsibility to uphold these values.
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Work Schedule: Friday, Saturday, and Sunday (7:00 am-7:30 pm)
Occ Summary Ability to analyze insurance coverage and benefits for services to ensure timely authorization based on established payment relationships with patients, physicians, co‑workers, and supervisors.
The position is responsible for high production, accurately completing patient accounts according to departmental protocol, greeting and assisting visitors and patients. Explain policies and calculate due amounts according to PRMO credit and collection policies.
Implement appropriate work independently. Must develop and maintain professional relationships and comply with policies and procedures on insurance plan contracts and guidelines. Document billing system understandings, explain bills, business processes, or regulations. Requires working knowledge of uninsured patients and determine the appropriate source of liability/payment based on policy and sources.
Coverage and clinical information are requested to resolve issues relating to facilitating payment sources for authorization, certification, and/or authorizations as appropriate. Compliance with regulatory agencies, including insurance claim departmental policies, and collecting cash payments appropriately for all patients. Reconcile daily and work independently. Ensure accurate patient demographics and financial data. Resolve registration and registration functions. Ensure all insurance arrangements are made and inform patients of their financial liability before discussing options and screening for government funding, pre‑admission, admission, and pre‑requirements before the patients’ arrival for services. Arrange payment reimbursement and obtain all prior authorizations. Perform complete admission, register, preregister, and remedy denials expediently. Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy.
Compile statistics for budgetary and reporting purposes. Collection ensures all accounts are processed accurately and efficiently, and assist financially responsible persons in arranging payment. Make referrals for financial counseling, determine necessity of third‑party sponsorship, and process patients according to policy and procedure. Examine insurance policies and third‑party materials for sources of payment. Inform the attending physician of the patient’s 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. Resolve problems, gather documentation to support proper handling of inquiries and complaints, assist with departmental coverage as requested, enter and update referrals, and communicate with insurance carriers regarding data. Perform multiple tasks and remain service‑oriented. Must understand and comply with principles. The job allows working in an Emergency Department environment.
Minimum Qualifications Duke is an Equal Opportunity Employer committed to providing employment opportunities 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.
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 of experience working in hospital service access, clinical service access, a physician's 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, Licenses, Certifications None required.
Equal Employment Opportunity 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, all members of our community must feel secure and welcome, have their contributions respected, and all voices heard. All members of our community have a responsibility to uphold these values.
#J-18808-Ljbffr