What are the responsibilities and job description for the FINANCIAL CARE COUNSELOR position at Duke?
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 that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.
Friday-Sunday 7:00a m-7:30pm WEO Shift differential
Occu pationalSummary
- A ccurately complete patient accounts based on departmental protocol, policies and procedures, and compliancewith regulatory agencies, to include but not limited to pre-admission,admission, pre-registration and registration functions.
- Ensure all insu rance requirements are met prior to patients' arrival and inform pat ients of their financial liability priortoarrival for services.
- Arrange payment optionswith the patients and screens pa tients for government funding sources.
Work Perf ormed
- Analyze insurance coverage and benefits for service to ensure timely.
- Obtain authorizations based payment. on insurance plan contracts and guidelines .
- Documentbilling system.
- Ex plain bills provides assistanceto visitors and patients.
- Explain policies anddepartmental coverage as requested.
- Calculateandaccording toPRMO credit and collection po licies.
- Implement appropriate collect cash pay ments appropriately forall patients.
- Reconcile daily necessity of third partysponsorship and process patients in a ccordance reimbursement.
- Obtain all Prior Auth orization Certification and/orauthorizations as appropriate.
- Facilitate payment sources for uninsured patients.
- Determine ifpatient's conditionis the result of an acci dent and perform completeresearch to determine the appropriate source of liability/payment.
- Admit, register and pre-reg ister patients withaccurate patient demographic and financial data.< /span>
- Resolveinsurance claim rejections/denials and reme dyexpediently.
- Evaluate diagnoses to ensure complia nce with the Local Mcessary toensure all accounts are processed accurate lyandefficiently.
- Perform those duties ne/span>
- Compile departmentalstatistics for budgetaryand reporting purpos es.
- collection actions andassist financially r esponsible persons inarranging payment.
- Make re ferral forfinancialcounseling.
- Determine with policy and procedure.
- Examine insurance polici es and other thirdparty sponsorship materials forsources of payment.
- Informattending physicianof patient financial har dship.
- Complete the managed care waiver form f or patients considered outof network and receiving services at a red uced benefit level.
- Update the billing system to reflect the insurance status of the patient.
- Re fer patients to theManufacturer Drug program as needed for medicatio ns.
- Greet and procedures, and resolves problem s.
- Gathers necessarydocumentation to support p roperhandling of inquiriesand complaints.
- Assi st with according topolicy and procedure.
- Ente rand update referrals as required.
- Communicate with insurance carriersregarding clinicalinformation requested and tores olve issues relating to coverage
Knowledge,Skills an d Abilities
- Excelle nt communication skills, oral and written.
- Abi lity toanalyze relationships with patients, physicians, co-workersand supervisors. data, perform multiple tasks and work independently.
- Must be abletodevelopand maintain professional,service -oriented working,
- Must be able to understand and comply with policies and procedures.
Level Character istics
- Position responsible forhigh pr oduction generated accurately in accordance with establishedbusiness processes or regulation.
Requiresworking knowl edge of compliance principles. Job allows the opportunity to workindepen dently.
Excellent commu nication skills, oral and written. Ability to analyze data,perform multi ple tasks and work independently. Must be able to develop andmaintain pr ofessional,service-oriented working relationships with patients, physici ans, co-workers and supervisors.Must be able to understandand comply wit h policies and procedures.
Po sition responsible forhigh production generated accuratelyin accordance with established business processes or regulation. Requiresworking knowl edge of compliance principles.Job allows the opportunityto work independ ently.
Minimum Qualifications
Duke is an Affirmative Action/Equal Opportunity Employer committed toproviding employment opportunity without regard to an indiv idual's age,color, disability, gender, gender expression, gender identit y, geneticinformation, national origin, race, religion, sex, sexual orie ntation,or veteran status.
Duke aspires to create a c ommunity built on collaboration,innovation, creativity, and belonging. O ur collective success depends onthe robust exchange of ideas—an exchange that is best when the richdiversity of our perspectives, backgrounds, a nd experiences flourishes.To achieve this exchange, it is essential that all members of thecommunity feel secure and welcome, that the contribut ions of allindividuals are respected, and that all voices are heard. All members ofour community have a responsibility to uphold these values.
Essential Physical Job Functions: Certain jobs at Duke University andDuke University Health System may include essential job f unctions thatrequire specific physical and/or mental abilities. Addition alinformation and provision for requestsfor reasonable accommodation wi llbe provided by each hiring department.
E ducation
Work requires knowledge of basic grammar and mathematic al principlesnormally required through a high school education, with som epostsecondary education preferred. Additional training or workingknowle dge of related business.
Experience
Two years experie nce working in hospital service access, clinicalservice access, physicia n office or billing and collections. Or, anAssociate's degree in a healt hcare related field and one year ofexperience working with the public. O r, a Bachelor's degree and one yearof 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.
