Financial Care Counselor - DRAH PT/OT (Knightdale)

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 the role

The Patient Revenue Management Organization (PRMO) is the fully integrated, centralized revenue cycle organization supporting the entire Duke Health system. This role involves streamlining revenue cycle functions, including scheduling, registration, coding, billing, and other essential revenue tasks 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. This position ensures accurate completion of patient accounts based on departmental protocols, policies, and compliance with regulatory agencies.

Responsibilities

• Analyze insurance coverage and benefits to ensure timely payment and obtain authorizations based on insurance plan contracts and guidelines.
• Document and update the billing system, explaining bills and providing assistance to patients and visitors.
• Explain policies, departmental coverage, and calculate patient financial liability according to PRMO credit and collection policies.
• Collect cash payments, reconcile daily transactions, and process patients in accordance with reimbursement requirements.
• Obtain all necessary prior authorizations, certifications, and facilitate payment sources for uninsured patients.
• Determine if a patient's condition is the result of an accident and research appropriate sources of liability/payment.
• Admit, register, and pre-register patients with accurate demographic and financial data.
• Resolve insurance claim rejections/denials expediently and evaluate diagnoses for compliance with Medicare Review Policy.
• Compile departmental statistics for budgetary and reporting purposes, and assist financially responsible persons in arranging payment.
• Refer patients for financial counseling and determine eligibility for financial assistance according to policy.
• Examine insurance policies and third-party sponsorship materials for payment sources.
• Inform attending physicians of patient financial hardships and complete managed care waiver forms for out-of-network patients.
• Update the billing system to reflect insurance status and refer patients to Manufacturer Drug programs as needed.
• Greet patients, explain procedures, resolve problems, and gather documentation to support inquiries and complaints.
• Assist with tasks according to policy, enter and update referrals, and communicate with insurance carriers regarding clinical information and coverage issues.

Requirements

• Excellent oral and written communication skills.
• Ability to analyze data, perform multiple tasks, and work independently.
• Capability to develop and maintain professional, service-oriented working relationships.
• Understanding and compliance with policies and procedures.
• Working knowledge of compliance principles.

Qualifications

Education: Work requires knowledge of basic grammar and mathematical principles, typically acquired through a high school education. Some postsecondary education or additional training in a related business field is preferred.

Experience: Two years of experience in hospital service access, clinical service access, physician office, or billing and collections. Alternatively, 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.

Benefits

• DUHS Commitment Bonus Program: $5,000 (paid in two installments over 12 months in 6-month increments). Eligibility: New hires who have not worked for Duke University in the past 12 months at the time of offer.

Schedule

Work hours: 7:00 AM – 6:00 PM. Main shifts vary:

• Monday – Wednesday: 9:00 AM – 6:00 PM
• Thursday – Friday: 8:30 AM – 5:00 PM