Financial Care Counselor - Spine

Duke Careers•Raleigh, NC

6h•Onsite

About The Position

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. Duke Health Integrated Practice comprises more than 110 primary and specialty outpatient clinics, extending the reach of the Duke Health mission across the state of North Carolina. We are seeking a Financial Care Counselor in our Piedmont Spine Specialists located in Raleigh, NC to be an integral member of the healthcare team to provide direct and indirect care to patients.

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.

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.
Reconcile daily cash deposit.
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.
Make referral for financial counseling.
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.
Assist with departmental coverage as requested.
Obtain authorizations based on insurance plan contracts and guidelines.
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.