Financial Care Counselor - DRAH (Midtown)

340B Health; Raleigh (NC); On-site; USD 40,000 - 70,000; Full time

Job summary

Join a forward-thinking healthcare organization as a Financial Care Counselor, where your role is pivotal in ensuring seamless patient financial experiences. You'll be at the forefront of patient interactions, assisting with insurance coverage analysis, payment processing, and providing essential support to patients navigating their financial responsibilities. This position offers the chance to work in a dynamic environment that values compassion and collaboration, making a significant difference in the lives of patients and their families. Embrace this opportunity to grow your career in a supportive and innovative healthcare setting.

Benefits

Commitment Bonus Program

Health benefits

Professional development opportunities

Qualifications

• High school diploma required; some postsecondary education preferred.
• 2 years experience in hospital service access or billing and collections.

Responsibilities

• Analyze insurance coverage and ensure timely processing.
• Admit, register, and pre-register patients accurately.
• Resolve insurance claim rejections and denials promptly.

Skills

Excellent oral and written communication skills

Ability to analyze relationships

Ability to perform multiple tasks independently

Service-oriented attitude

Education

High school diploma or equivalent

Some postsecondary education

Associate’s degree in healthcare-related field

Bachelor's degree

Job description

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.

Duke Raleigh Midtown Specialty Rehab

Financial Care Counselor

Hours Availability: 6:30am - 5:30pm, Shift hours vary based on department needs

Location: 5920 Sandy Forks Rd, Raleigh, NC 27609

This is a front-facing position.

*** DUHS Commitment Bonus Program $5000.00 (paid in 2 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 to receive the commitment bonus.

Position Overview

Duke University Health System - Patient Revenue Management Office (PRMO) seeks to hire a Financial Care Counselor who will embrace our mission of Advancing Health Together.

Responsibilities include accurately completing patient accounts based on departmental protocols, policies, procedures, and compliance with regulatory agencies. This involves pre-admission, admission, pre-registration, and registration functions.

Work Performed

1. Analyze insurance coverage and benefits to ensure timely processing.
2. Obtain authorizations based on insurance plan contracts and guidelines.
3. Document billing system entries.
4. Explain bills and provide assistance to visitors and patients.
5. Explain policies and departmental coverage as requested.
6. Calculate and process payments according to PRMO credit and collection policies.
7. Implement appropriate cash collection procedures for all patients.
8. Reconcile daily third-party sponsorships and process reimbursements.
9. Obtain all necessary Prior Authorization Certifications and authorizations.
10. Facilitate payment sources for uninsured patients.
11. Research and determine liability/payment sources for patients injured in accidents.
12. Admit, register, and pre-register patients with accurate demographic and financial data.
13. Resolve insurance claim rejections/denials promptly.
14. Evaluate diagnoses for compliance with Medicare policies.
15. Ensure all accounts are processed accurately and efficiently.
16. Compile departmental statistics for budgeting and reporting.
17. Assist in collection actions and help financially responsible persons arrange payments.
18. Refer patients for financial counseling.
19. Review insurance policies and third-party sponsorships for payment sources.
20. Inform physicians of patient financial hardships.
21. Complete managed care waiver forms for out-of-network patients receiving reduced benefits.
22. Update billing systems to reflect insurance status.
23. Refer patients to Manufacturer Drug programs as needed.
24. Greet and assist patients, resolve problems, and handle inquiries.
25. Update referrals and communicate with insurance carriers regarding clinical information and coverage issues.

Knowledge, Skills, and Abilities

• Excellent oral and written communication skills.
• Ability to analyze relationships with patients, physicians, co-workers, and supervisors.
• Ability to perform multiple tasks independently.
• Develop and maintain a professional, service-oriented attitude.
• Understand and comply with policies and procedures.

Level Characteristics

• Responsible for high-volume, accurate work in accordance with established processes and regulations.
• Requires knowledge of compliance principles and the ability to work independently.

Minimum Qualifications

Education

High school diploma or equivalent required; some postsecondary education preferred. Additional training or related business experience is a plus.

Experience

At least two years of experience in hospital service access, clinical service access, physician office, or billing and collections. Alternatively, an Associate’s degree in a healthcare-related field with one year of experience, or a Bachelor's degree with one year of experience working with the public.

Degrees, Licensures, Certifications

None required.

Equal Opportunity Statement

Duke is an Equal Opportunity Employer committed to diversity and inclusion. We encourage all qualified individuals to apply, regardless of age, race, gender, disability, or other protected status.

Community and Physical Job Functions

We value a community built on collaboration, innovation, and respect. All members are responsible for maintaining a secure and welcoming environment. Additional physical and mental abilities required for specific roles will be addressed by each department.