SHSMD Career Center
Ashland, Wisconsin
Durham, North Carolina
Raleigh, North Carolina
Posted: 12-May-23
Location: Durham, North Carolina
Salary: Open
Categories:
Internal Number: 231582
***$2500.00 Sign On Bonus (2 installments over 12 months - 6-month increments) ***
Work Hours
Monday - Thursday 10:00a-8:30p
Duke University Health System - Patient RevenueManagement 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, including but not limited to pre-admission, admission, pre-registration, and registration functions.
Ensure all insurance requirements are met before patients' arrival and inform patients of their financial liability before arrival for services. Arrange payment options with the patients and screen patients for government funding sources.
Work Performed
- Analyze insurance coverage and benefits for service to ensure timely.
- Obtain authorizations based on payment on insurance plan contracts and guidelines.
- Document billing system.
- Explain bills and assists visitors and patients.
- Explain policies and departmental coverage as requested.
- Calculate and according to PRMO credit and collection policies.
- Implement appropriate collect cash payments appropriately for all patients.
- Reconcile daily necessity of third-party sponsorship and process patients by reimbursement.
- Obtain all Prior Authorization Certification and /or authorizations as appropriate.
- Facilitate payment sources for uninsured patients.
- Determine if the 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 a referral for financial counseling.
- Determine policy and procedure.
- Examine insurance policies and other third-party sponsorship materials for sources of payment.
- Inform the attending physician of the patient's 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 procedures, and resolves problems.
- Gathers necessary documentation to support the 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 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. data, perform multiple tasks, and work independently.
- Must be able to develop and maintain professional, service-oriented working,
- Must be able to understand and comply with policies and procedures.
Level Characteristics
- Position responsible for high production generated accurately by established business processes or regulations.
- Requires working knowledge of compliance principles. The job allows the opportunity to work independently.
MINIMUM QUALIFICATIONS
Education
Work requires knowledge of basic grammar and mathematical principles normally required through high school education, with some post-secondary education preferred. Additional training or working knowledge of the related business.
Experience
Two years experience working in hospital service access, clinical service access, physician office, or billing and collections. Or, 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 opportunities 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.
Minimum Qualifications
Education
Work requires knowledge of basic grammar and mathematical principles normally required through high school education, with some postsecondary education preferred. Additional training or working knowledge of the 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 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.
