Financial Care Counselor - Duke Health Center (Morreene Rd)

Duke University•Durham, NC

65d•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. About Duke Health's Patient Revenue Management Organization Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions. Occ Summary Accurately complete patient accounts based onlicy. Perform those duties necessary to ensure allaccounts are proces sedEvaluate diagnosesto ensure compliance with the LocalMedicare Review Podepartmental protocol,policies andprocedures, and compliance with re gulatory agencies, toinclude but not limited to pre-admission, admission ,pre-registrationand registration functions. Ensure all insurance requir ements are met prior to patients' arrival and inform patients of theirfin ancialliability prior to arrival for services. Arrange payment options w iththe patients and screens patients for government funding sources.

Requirements

Excellent communica tion skills, oral and written.
Ability to analyzedata, perform multiple tasks and work independently.
Must be able todevelop and maintain profes sional, service-oriented workingrelationships with patients, physicians, co-workers and supervisors.
Must be able to understand and comply with p olicies and procedures.
Work requires knowl edge of basic grammar and mathematical principlesnormally required throu gh a high school education, with somepostsecondary education preferred.
Additional training or workingknowledge of related business.
Two years experience working in hospital service acce ss, clinicalservice access, physician office or billing and collections.
Or, anAssociate'sdegree in a healthcare related field and one year ofe xperience working with the public.
Or, a Bachelor's degree and one yearo f experience working with the public.

Responsibilities

Analyze insurance coverage and benefits forservice to ensure timelyreimbursement.
Obtain all Prior Authorization Certification and/orauthorizations as appropriate.
Facilitate payment so urces for uninsuredpatients.
Determine if patient's condition is the res ult of an accidentand perform complete research to determine the appropr iate source ofliability/payment.
Admit, register and pre-register patien ts withaccurate patient demographic and financial data.
Resolve insuranc eclaim rejections/denials and remedy expediently.
Calculate andcollect ca sh payments appropriately for all patients.
Reconcile dailycash deposit. accurately and efficiently.
Compile departmentalstatistics for budgetary and reporting purposes.
Explain billsaccording to PRMO credit and collect ion policies.
Implement appropriatecollection actions and assist financially responsible persons inarranging payment.
Make referral for financia l counseling.
Determinenecessity of third party sponsorship and processp atients in accordancewith policy and procedure.
Examine insurance polici es and other thirdparty sponsorshipmaterials for sources of payment.
Inform attendingphysician of patient financial hardship.
Complete the manag ed carewaiver form for patients considered out of network and receivings ervices at a reduced benefit level.
Update the billing system toreflectthe insurance status of the patient.
Refer patients to theManufacturervi sitors and patients.
Explain policies andprocedures, and resolves problems . Gathers necessary documentation tosupport proper handling of inquiries and complaints.
Assist withdepartmental coverage as requested.
Obtain au thorizations basedon insurance plan contracts and guidelines.
Document b illing systemaccording to policy and procedure.
Enter and updatereferrals asrequired.
Communicate with insurance carriers regarding clinicalinfo rmation requested and to resolve issues relating to coverage andpayment.