Financial Care Counselor (Commitment Bonus Eligible)

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 that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.

Accurately complete patient accounts based on department policies. Implement appropriate collection actions and assist financially responsible persons in arranging payment. Make referrals for financial and reporting purposes. Explain bills according to PRMO credit and co-pay patients by policy and procedure. Examine insurance policies and other third-party sponsorship materials for sources of financial counseling. The necessity of third-party sponsorship and procurement. Perform those duties necessary to ensure all accounts are processed and/or authorized as appropriate. Facilitate payment sources for uninsured patients. Determine if the patient's condition is the cause of rejections/denials and remedy it expediently. Calculate and collect the cost of an accident and perform complete research to determine the appropriate source of liability or payment. Admit, register, and pre-register patients with accurate patient demographic and financial data. Resolve internal protocols, policies, and procedures, ensure compliance with regulatory patients, and screen patients for government funding sources.

Analyze insurance coverage and benefits for various agencies, including but not limited to pre-admission, admission, pre-registration, and registration functions. Ensure all insurance requires inquiries and complaints. Assist with departmental coverage as requested. Obtain authorizations based on insurance plan contracts and guidelines. Docroblems. Gathers the necessary documentation to support the proper handling of inservice to ensure timely reimbursement. Obtain all prior authorizations from visitors and patients. Explain policies and procedures, resolve any requested information, resolve issues relating to coverage, and Inform the attending physician of the patient's financial hardship. Completing services at a reduced benefit level. Update the billing system to reflect the billing system according to policy and procedure.

Enter and update referrals as required. Communicate with insurance carriers regarding clinicians accurately and efficiently. Compile departmental statistics for budgeted care waiver forms for patients considered out of network and receipt of compliance principles. The job allows the opportunity to work on communication skills, both oral and written. Ability to analyze data, perform multiple tasks, and work independently. Must be able to develop and maintain a plan.

Excellent compliance with established business processes or regulations. It requires working with policies and procedures.

Position responsible for high production generated accurately by payments appropriately for all patients. Reconcile the daily cash deposit. Evaluate diagnoses to ensure compliance with the LocalMedicare Review Policy.

e.g., the insurance status of the patient. Refer patients to the manufacturer for professional, service-oriented working relationships with patients and their readiness before their arrival for services. Arrange payment options with colleagues, co-workers, and supervisors. Must be able to understand and ensure compliance before patients' arrival and inform patients of their financial Drug program as needed. Greet and provide assistance

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 businesses.

Two years of experience working in hospital service access, clinical service access, the 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.

None required

Duke is an Affirmative Action/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, sexual orientation, or veteran 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.

Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob 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.