Financial Care Counselor - Duke Cancer Center Raleigh

About the role

The Duke University Health System's Patient Revenue Management Office (PRMO) seeks to hire a Financial Care Counselor to support the Duke Cancer Center Raleigh.

Responsibilities

• Analyze insurance coverage and benefits for service to ensure timely.
• Obtain authorizations based on payment on insurance plan contracts and guidelines.
• Document billing system.
• Explain bills and provide assistance to visitors and patients.
• Explain policies and departmental coverage as requested.
• Calculate and implement appropriate collect cash payments appropriately for all patients.
• Reconcile daily necessity of third party sponsorship and process patients in accordance with 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.
• Collect 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.
• Aid in entering and updating referrals as required.
• Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage.

Qualifications

• 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.
• Requires working knowledge of compliance principles.

Skills

• Knowledge of basic grammar and mathematical principles.
• Knowledge of hospital service access, clinical service access, physician office or billing and collections.
• Associate's degree in a healthcare related field and one year of experience working with the public.
• Bachelor's degree and one year of experience working with the public.

Benefits

• Commitment bonus of $5000.00 (paid in 2 installments over 12 months - 6 month increments).

Pay

• $Competitive salary.

Schedule

• Flexible schedule to accommodate patient needs.