Financial Care Counselor - DRAH Outpatient Rehab

340B Health; Raleigh (NC); On-site; USD 40,000 - 60,000; Full time

Job summary

Duke University Health System is seeking a Financial Care Counselor to support patient financial needs in a front-facing role. This position involves ensuring compliance with insurance requirements, assisting patients with payment options, and analyzing billing issues to promote financial care excellence.

Qualifications

• Two years of experience in hospital service access or related field.
• Associate's degree in healthcare or Bachelor's degree with public experience preferred.

Responsibilities

• Complete patient accounts with compliance to departmental protocols.
• Analyze insurance coverage and document billing system activities.
• Resolve insurance claim rejections and assist patients with payment options.

Skills

Communication

Analytical skills

Relationship management

Independence

Education

High school education with some postsecondary education preferred

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 supporting the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.

Duke Raleigh Outpatient Rehab

Financial Care Counselor - This is a front-facing position

Hours of availability: M-F 6:30am - 5:30pm; main shift 9:00am - 5:30pm. Shift based on Department needs.

*** 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.

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.

Accurately complete patient accounts based on departmental protocol, policies, procedures, and compliance with regulatory agencies, including 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 screen patients for government funding sources.

Work Performed

1. Analyze insurance coverage and benefits for service to ensure timely processing.
2. Obtain authorizations based on payment on insurance plan contracts and guidelines.
3. Document billing system activities.
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 necessity of third-party sponsorship and process patients in accordance with reimbursement procedures.
9. Obtain all Prior Authorization Certifications and/or authorizations as appropriate.
10. Facilitate payment sources for uninsured patients.
11. Determine if patient's condition is the result of an accident and perform complete research to determine the appropriate source of liability/payment.
12. Admit, register, and pre-register patients with accurate demographic and financial data.
13. Resolve insurance claim rejections/denials and remedy expediently.
14. Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy.
15. Perform duties necessary to ensure all accounts are processed accurately and efficiently.
16. Compile departmental statistics for budgetary and reporting purposes.
17. Assist financially responsible persons in arranging payments and make collection actions.
18. Make referrals for financial counseling.
19. Examine insurance policies and other third-party sponsorship materials for sources of payment.
20. Inform attending physicians of patient financial hardship.
21. Complete the managed care waiver form for patients considered out of network and receiving services at a reduced benefit level.
22. Update the billing system to reflect the insurance status of the patient.
23. Refer patients to the Manufacturer Drug Program as needed for medications.
24. Greet and assist patients, resolve problems, and gather necessary documentation for inquiries and complaints.
25. Enter and update referrals as required.
26. Communicate with insurance carriers regarding clinical information requested and resolve coverage issues.

Knowledge, Skills, and Abilities

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

Level Characteristics

• Responsible for high production accuracy in accordance with established business processes or regulations.
• Requires working knowledge of compliance principles. Ability to work independently.

MINIMUM QUALIFICATIONS

Education

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 is beneficial.

Experience

Two years of experience working 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

Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy-related conditions), sexual orientation, or military status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this, all community members should feel secure and welcome, with their contributions respected and voices heard. All members have a responsibility to uphold these values.

Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essential job functions that require specific physical and/or mental abilities. Additional information and requests for reasonable accommodations will be provided by each hiring department.