Duke University Health System
Financial Care Counselor - DUH Periop
Duke University Health System, Durham, North Carolina, United States, 27703
Financial Care Counselor – DUH Periop
Overview
At Duke Health, we are driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. Join us and discover how we can advance health together.
We seek a Financial Care Counselor who will embrace our mission of Advancing Health Together and support the Patient Revenue Management Organization – Duke Health's fully integrated, centralized revenue cycle organization.
Work Hours DUHS Commitment Bonus Program: $5000.00 (paid in two 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.
Responsibilities
Accurately complete patient accounts based on departmental protocol, policies and 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 and inform patients of their financial liability before services.
Arrange payment options with patients and screen patients for government funding sources.
Analyze insurance coverage and benefits for services to ensure timely payment.
Obtain authorizations based on payment 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 implement appropriate collections and cash payments for all patients.
Reconcile daily necessary third‑party sponsorship and process patients in accordance with reimbursement.
Obtain all prior authorization certifications and/or authorizations as appropriate.
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 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.
Assist financially responsible persons in arranging payment.
Make referrals for financial counseling.
Determine policies and procedures for payment sources.
Examine insurance policies and other third‑party sponsorship materials for payment sources.
Inform attending physicians of patient financial hardship.
Complete managed care waiver forms for patients considered out of network receiving reduced benefit level services.
Update the billing system to reflect the insurance status of the patient.
Refer patients to the manufacturer drug program as needed for medications.
Greet patients and resolve problems and procedures.
Gather necessary documentation to support proper handling of inquiries and complaints.
Assist according to policy and procedure.
Enter and update referrals as required.
Communicate with insurance carriers regarding clinical information requested and resolve coverage issues.
Knowledge, Skills and Abilities
Excellent communication skills, oral and written.
Ability to analyze relationships with patients, physicians, co‑workers, and supervisors.
Ability to perform multiple tasks and work independently.
Understand and comply with policies and procedures.
Minimum Qualifications
Education: High school education with knowledge of basic grammar and mathematical principles. Some postsecondary education preferred.
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.
Licenses/Certifications: None required.
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.
Equal Employment Opportunity Statement 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.
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We seek a Financial Care Counselor who will embrace our mission of Advancing Health Together and support the Patient Revenue Management Organization – Duke Health's fully integrated, centralized revenue cycle organization.
Work Hours DUHS Commitment Bonus Program: $5000.00 (paid in two 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.
Responsibilities
Accurately complete patient accounts based on departmental protocol, policies and 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 and inform patients of their financial liability before services.
Arrange payment options with patients and screen patients for government funding sources.
Analyze insurance coverage and benefits for services to ensure timely payment.
Obtain authorizations based on payment 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 implement appropriate collections and cash payments for all patients.
Reconcile daily necessary third‑party sponsorship and process patients in accordance with reimbursement.
Obtain all prior authorization certifications and/or authorizations as appropriate.
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 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.
Assist financially responsible persons in arranging payment.
Make referrals for financial counseling.
Determine policies and procedures for payment sources.
Examine insurance policies and other third‑party sponsorship materials for payment sources.
Inform attending physicians of patient financial hardship.
Complete managed care waiver forms for patients considered out of network receiving reduced benefit level services.
Update the billing system to reflect the insurance status of the patient.
Refer patients to the manufacturer drug program as needed for medications.
Greet patients and resolve problems and procedures.
Gather necessary documentation to support proper handling of inquiries and complaints.
Assist according to policy and procedure.
Enter and update referrals as required.
Communicate with insurance carriers regarding clinical information requested and resolve coverage issues.
Knowledge, Skills and Abilities
Excellent communication skills, oral and written.
Ability to analyze relationships with patients, physicians, co‑workers, and supervisors.
Ability to perform multiple tasks and work independently.
Understand and comply with policies and procedures.
Minimum Qualifications
Education: High school education with knowledge of basic grammar and mathematical principles. Some postsecondary education preferred.
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.
Licenses/Certifications: None required.
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.
Equal Employment Opportunity Statement 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.
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