Financial Care Counselor - Duke Health Center (Morreene Rd)

About the role

Duke Health Center (Morreene Rd) is seeking a Financial Care Counselor to support the Patient Revenue Management Organization (PRMO), the fully integrated, centralized revenue cycle organization that streamlines scheduling, registration, coding, billing, and other essential revenue functions for Duke Health.

Responsibilities

• Accurately complete patient accounts in accordance with departmental protocols, policies, procedures, and regulatory compliance, including 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 before services are provided.
• Arrange payment options with patients and screen patients for government funding sources.
• Analyze insurance coverage and benefits to ensure timely and accurate payment based on insurance plan contracts and guidelines.
• Document billing system entries and explain bills to visitors and patients.
• Calculate credits and collections according to PRMO policies; implement appropriate cash collection procedures for all patients.
• Reconcile daily third-party sponsorships and process reimbursements as necessary.
• Obtain all prior authorization certifications and/or authorizations as appropriate.
• Facilitate payment sources for uninsured patients and determine if a patient’s condition is the result of an accident, performing research to identify appropriate liability/payment sources.
• 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.
• Initiate collection actions and assist financially responsible persons in arranging payment.
• Make referrals for financial counseling and examine insurance policies and third-party sponsorship materials for sources of payment.
• Inform attending physicians of patient financial hardship and complete managed care waiver forms for out-of-network patients receiving services at reduced benefit levels.
• Update the billing system to reflect patient insurance status and refer patients to Manufacturer Drug programs as needed.
• Greet patients, gather necessary documentation to support inquiries and complaints, and resolve problems.
• Enter and update referrals as required and communicate with insurance carriers regarding clinical information requests and coverage issues.

Knowledge, Skills and Abilities

• Excellent oral and written communication skills.
• Ability to analyze relationships with patients, physicians, coworkers, and supervisors.
• Capacity to handle multiple tasks and work independently.
• Ability to develop and maintain professional, service-oriented working relationships.
• Must be able to understand and comply with policies and procedures.

Minimum Qualifications

Education

Work requires knowledge of basic grammar and mathematical principles normally attained through a high school education, with some postsecondary education preferred. Additional training or working knowledge of related business is a plus.

Experience

• Two years of 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.

Benefits

Eligible new hires may receive the DUHS Commitment Bonus Program of $5,000, paid in two 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.