Financial Care Counselor - Cancer Center Financial Care

About the role

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.

Patient Revenue Management Organization – Pursue your passion for caring with the Patient Revenue Management Organization, which is the 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 for Duke Health.

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

• Accurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to 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 prior to arrival for services.
• Arrange payment options with the patients and screen patients for government funding sources.
• Analyze insurance coverage and benefits for service to ensure timely processing.
• Obtain authorizations based on insurance plan contracts and guidelines.
• Document billing system information.
• Explain bills and provide assistance to visitors and patients.
• Explain policies and departmental coverage as requested.
• Calculate amounts according to PRMO credit and collection policies.
• Implement appropriate collection of cash payments for all patients.
• Reconcile daily third‑party sponsorship requirements and process patients in accordance with reimbursement guidelines.
• Obtain all Prior Authorization Certification and/or authorizations as appropriate.
• Facilitate payment sources for uninsured patients.
• Determine if a patient's condition is the result of an accident and perform complete research to determine the appropriate source of liability/payment.
• Admit, register, and pre‑register patients with accurate patient 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.
• Perform collection actions and assist financially responsible persons in arranging payment.
• Make referrals for financial counseling.
• Examine insurance policies and other third‑party sponsorship materials for sources of payment.
• Inform attending physician of patient financial hardship