Financial Care Counselor - DRAH PT/OT & Speech (Brier Creek)

About the role

The Patient Revenue Management Organization at Duke Health is a 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.

Responsibilities

• Analyze insurance coverage and benefits for service to ensure timely.
• Avoidance of denial and remediating denials expeditiously.
• Arrange payment options with the patients and screens patients for government funding sources.
• Work with insurance carriers regarding clinical information requested and to resolve issues relating to coverage.
• Document billing system.
• Explain bills and provides assistance to visitors and patients.
• Calculate and according to PRMO credit and collection policies.
• Implement appropriate collect cash payments appropriately for all patients.
• Reconcile daily necessity of third party sponsorship and process patients in accordance reimbursement.
• Obtain all Prior Authorization Certification and/or authorizations as appropriate.
• Facilitate payment sources for uninsured patients.
• Determine if 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.
• Compile departmental statistics for budgetary and reporting purposes.
• Collection actions and assist financially responsible persons in arranging payment.
• Make referral for financial counseling.
• Determine with policy and procedure.
• Examine insurance policies and other third party sponsorship materials for sources of payment.
• Inform attending physician of patient 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.
• Greet and procedures, and resolves problems.
• Gathers necessary documentation to support proper handling of inquiries and complaints.
• Enter and update referrals as required.
• Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage.

Requirements

• Excellent communication skills, oral and written.
• Ability to analyze relationships with patients, physicians, co-workers and supervisors.
• Must be able to develop and maintain professional, service-oriented working relationships.
• Must be able to understand and comply with policies and procedures.
• Level Characteristics
• Position responsible for high production generated accurately in accordance with established business processes or regulation.
• Requires working knowledge of compliance principles.

Qualifications

• Education: Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with 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.

Skills

• Knowledge of basic grammar and mathematical principles.
• Ability to analyze relationships with patients, physicians, co-workers and supervisors.
• Develop and maintain professional, service-oriented working relationships.
• Understand and comply with policies and procedures.

Benefits

No specific benefits are mentioned in the job posting.

Pay

$5000.00 commitment bonus paid in 2 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.

Schedule

Work Hours DUHS Commitment Bonus Program