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

340B Health; Raleigh (NC); On-site; USD 40,000 - 55,000; Full time

Job summary

Duke University Health System is seeking a Financial Care Counselor to support patient account management and facilitate financial arrangements. This role involves coordinating with patients regarding their financial responsibilities and ensuring compliance with regulatory requirements. Ideal candidates will possess strong communication and analytical skills, along with relevant experience in healthcare finance. Join a team dedicated to enhancing health together.

Qualifications

• Two years in hospital service access or billing and collections preferred.
• Associate's or Bachelor's degree with experience considered.
• Knowledge of basic grammar and math.

Responsibilities

• Complete patient accounts based on protocols and compliance.
• Analyze insurance coverage and arrange payment options.
• Document billing information and assist patients with inquiries.

Skills

Communication Skills

Analytical Skills

Problem Solving

Education

High School Diploma or equivalent

Postsecondary Education

Job description

PRMO, established in 2001, 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. Our mission is to deliver 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.

Compensation: 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 are eligible.

Duke University Health System - PRMO seeks to hire a Financial Care Counselor who will embrace our mission of Advancing Health Together.

Key Responsibilities:

• Complete patient accounts accurately based on departmental protocols, policies, procedures, and regulatory compliance, including pre-admission, admission, pre-registration, and registration functions.
• Ensure all insurance requirements are met prior to patient arrival and inform patients of their financial liability.
• Arrange payment options and screen patients for government funding sources.
• Analyze insurance coverage and benefits to ensure timely processing.
• Obtain necessary authorizations based on insurance plans and guidelines.
• Document billing information and explain bills to visitors and patients.
• Calculate and process payments according to PRMO policies.
• Reconcile third-party sponsorships and process reimbursements.
• Facilitate payment sources for uninsured patients.
• Research liability/payment sources if patient's condition results from an accident.
• Register and pre-register patients with accurate demographic and financial data.
• Resolve insurance claim rejections/denials promptly.
• Evaluate diagnoses for compliance with Medicare policies.
• Ensure all accounts are processed accurately and efficiently.
• Compile departmental statistics for budgeting and reporting.
• Assist with collection actions and payment arrangements.
• Refer patients for financial counseling as needed.
• Review insurance policies and third-party sponsorships for payment sources.
• Inform physicians of patient financial hardships.
• Complete managed care waiver forms for out-of-network patients receiving reduced benefits.
• Update billing systems to reflect insurance status.
• Refer patients to manufacturer drug programs for medications.
• Greet patients, address procedures, and resolve issues.
• Gather documentation to support inquiries and complaints.
• Enter and update referrals as required.
• 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; 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 processes and regulations.
• Requires working knowledge of compliance principles and the ability to work independently.

Minimum Qualifications:

Education: Knowledge of basic grammar and math, typically through a high school education; postsecondary education preferred. Additional training or related work experience is beneficial.

Experience: Two years in hospital service access, clinical service access, physician office, or billing and collections; or an Associate's degree with one year of experience; or a Bachelor's degree with one year of experience.

Degrees, Licenses, Certifications: None required.

Duke is an Affirmative Action/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, sexual orientation, or veteran status.

We value diversity and strive to create an inclusive community where all members feel secure, respected, and heard. All community members share the responsibility to uphold these values.

Essential Physical Job Functions: Some roles may include specific physical and/or mental abilities requirements, with accommodations available upon request.