Financial Care Counselor - ENT and Oral Surgery - 1F
Duke University Health System
Location: Durham, North Carolina
Internal Number: 213028
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 Dukeâ€™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 University Health System - Patient Revenue Management Office (PRMO) seeks to hire a Financial Care Counselor who will embrace our mission of Advancing Health Together.
***$2500.00 Sign On Bonus (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 sign-on bonus.
Performs a variety of specialized tasks involved in verifying insurance eligibility and benefits, obtaining pre-certification and authorizations for healthcare, Oral Surgery and dental services and procedures as well as Dental Surgeries. Provides comprehensive financial counseling to patients regarding their Dental and Healthcare services. Collects co-payments, deductibles, prepayments and payments on outstanding balances. Schedules appointments for all Oral surgery and Dental appointments. Post Dental payments into the Kodak system.
· Register new patients at the time of their a ppointment request for all Dental and Oral Surgery referral, etc.
·Determine most appropriate provider, service, and location for appointment based on scheduling guidelines, provider preferences, and patient/referring provider for all Dental /Oral Surgery request.
·Serves as a resource and expert on division-specific scheduling guidelines including recommendations regarding access for Dental and Oral Surgery services.
·Request outside records, Dental X-Ray ensure receipt of records prior to scheduling any Dental services.
·Determine if scheduling Dental or Medical (TMJ)
·Verify insurance eligibility and benefits for reimbursement for any and all Dental Services.
·Responsible for scheduling all Oral Surgery/Dental appointments, received via telephone, email, internet, electronic medical record and fax.
·Call patient and educate them about Dental appointments and financial responsibilities.
·Create a referral for all Dental/Oral Surgery request into the system and attach to the referral to the Dental appointment.
Provide financial counseling to reach account resolution
·Provide financial counseling to patients regarding outstanding patient liability- co pays, coinsurance and (self-pay) balances for healthcare and Dental services.
·Estimate/determine fees for Dental services as well as medical and assist patients with expected payment they may be responsible for.
· Implement appropriate collection actions and assist financially responsible persons in arranging payments at the time of service.
·Inform provider of patient financial hardship such as no Dental insurance, charity care, etc.
·Request interpreter services when appropriate and notify provider/staff
·Counsel patients and completethe managed care waiver form forpatients considered out of network andreceiving Dental services.
·Obtain authorizations based on insurance plan contracts/guidelines, for Dental plans as well as medical plans and document in Maestro Care system per policy and procedure.
·Obtain authorization for all Dental procedures and Surgeries
· Update referrals as required in order to place the authorization for Dental services, etc within the referral.
·Communicate with physicians and medical staff to obtain clinical information required for the authorization process as needed.
·Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage and payment for specific patients and Dental services.
·Communicate with all Dental patients regarding their benefits resulting in approval or denials in a timely manner.
· Enter all prepayment amounts into the maestro system to ensure payment is made prior to all Dental procedures/surgeries
·Maintain spread sheet of all payments/as well as maintain receipts
Attend meetings andtraining sessions:
·Attend staff meetings and other clinic meetings as requested
·Participate in all system regulatory and policy training
·Attend FCC education sessions.
Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some post secondary education preferred. Additional training or working knowledge of related business.
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
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 essentialjob 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.
As a world-class academic and health care system, Duke Health strives to transform medicine and health locally and globally through innovative scientific research, rapid translation of breakthrough discoveries, educating future clinical and scientific leaders, advocating and practicing evidence-based medicine to improve community health, and leading efforts to eliminate health inequalities.