Financial Care Counselor - Duke Neurology of Raleigh

Job Summary

We are seeking a Financial Care Counselor to accurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to 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 prior to arrival for services. Arrange payment options with the patients and screens patients for government funding sources.

Job Duties And Responsibilities

• Analyze insurance coverage and benefits for service to ensure timely 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.
• Calculate and collect cash payments appropriately for all patients.
• Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy.
• Reconcile daily cash deposit.
• Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy.
• Calculate and collect cash payments appropriately for all patients.
• Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy.
• Perform those duties necessary to ensure all accounts are processed accurately and efficiently.
• Compile departmental statistics for budgetary and reporting purposes.
• Explain bills according to PRMO credit and collection policies.
• Implement appropriate collection actions and assist financially responsible persons in arranging payment.
• Determine necessity of third party sponsorship and process patients in accordance 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 provides assistance to visitors and patients.
• Explain policies and procedures, and resolves problems.
• Gathers necessary documentation to support proper handling of inquiries and complaints.
• Absorb and analyze insurance policies and other third party sponsorship materials for sources of payment.
• Make referral for financial counseling.
• Document billing system according to policy and procedure.
• Enter and update referrals as required.
• Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage and payment.

Job Eligibility Requirements

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

Job Hours

The schedule for this position is day shifts, Monday-Friday, with no weekends or holidays.