Financial Care Counselor - DRH Admissions

About the role

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

• Analyze insurance coverage and benefits for service to ensure timely.
• Absorb authorizations based payment on insurance plan contracts and guidelines.
• Document billing system.
• Explain bills provides assistance to visitors and patients.
• Explain policies and departmental coverage as requested.
• Calculate and according to PRMO credit and collection policies.
• Arrange payment options with the patients and screens patients for government funding sources.
• 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.
• Collect actions and assist financially responsible persons in arranging payment.
• 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.
• Aid and 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.

Skills

• Must be able to develop and maintain professional, service-oriented working.
• 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.

Minimum 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.