Financial Care Counselor - DRAH Outpatient Service Access (Float Position)

Duke University; Raleigh (NC); On-site; USD 40,000 - 70,000; Full time

Job summary

An established industry player seeks a Financial Care Counselor to join their team. In this role, you will be responsible for accurately completing patient accounts and ensuring compliance with insurance requirements. You will analyze coverage, assist patients with financial options, and resolve billing issues. This position offers an opportunity to work in a collaborative environment where your contributions directly impact patient care and financial processes. If you are passionate about healthcare and enjoy helping others navigate financial responsibilities, this role is perfect for you.

Benefits

Commitment Bonus of $5000

Collaborative work environment

Opportunities for professional development

Qualifications

• Knowledge of basic grammar and math principles required.
• Two years experience in hospital service access or billing.

Responsibilities

• Complete patient accounts accurately based on departmental protocols.
• Analyze insurance coverage and arrange payment options for patients.
• Resolve insurance claim rejections and assist patients.

Skills

Excellent communication skills

Analytical skills

Customer service orientation

Education

High school education

Postsecondary education

Associate's degree in healthcare

Bachelor's degree

Job description

PRMO Established in 2001, Patient Revenue Management Organization (PRMO) is a fully integrated, centralized revenue cycle organization supporting all of Duke Health, including Duke University Hospital, Duke Regional Hospital, Duke Raleigh Hospital, the Private Diagnostic Clinic, and Duke Primary Care. The PRMO focuses on streamlining the revenue cycle through enhanced management of scheduling, registration, coding, HIM operations, billing, collections, cash management, and customer service. The Mission of the PRMO is delivering quality service by enhancing the patient experience, providing financial security, and preserving Duke’s reputation and mission of advancing health together. Our Vision is to be recognized as a world class innovative revenue cycle organization that values our people, patients and performance.

Duke Raleigh Outpatient Service Access (Float Position)

Financial Care Counselor

Work hours: Hours ranging from 5:45 am to 7:00 pm depending on location.

*** 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 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.

Work Performed

• Analyze insurance coverage and benefits for service to ensure timely.
• Obtain authorizations based payment on insurance plan contracts and guidelines.
• Document billing system.
• Explain bills and provide assistance to visitors and patients.
• Explain policies and departmental coverage as requested.
• Calculate according to PRMO credit and collection policies.
• Implement appropriate cash collection for all patients.
• Reconcile daily necessity of third party sponsorship and process patients in accordance with 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.
• 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.
• Collection actions and assist financially responsible persons in arranging payment.
• Make referrals for financial counseling.
• Determine compliance 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 assist patients and resolve problems.
• Gather necessary documentation to support proper handling of inquiries and complaints.
• Assist 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.

Knowledge, Skills and Abilities

• Excellent communication skills, oral and written.
• Ability to analyze relationships with patients, physicians, co-workers, and supervisors.
• Must be able to develop and maintain professional, service-oriented working relationships.
• Must be able to understand and comply with policies and procedures.

Level Characteristics

• Position responsible for high production generated accurately in accordance with established business processes or regulation.
• Requires working knowledge of compliance principles. Job allows the opportunity to work independently.

MINIMUM QUALIFICATIONS

Education

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.

Experience

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.

Degrees, Licensures, Certifications

None required.

Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran 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 exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community 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 provision for requests for reasonable accommodation will be provided by each hiring department.