Financial Care Counselor - DUH Periop
Duke University Health System, Durham, NC, United States
At Duke Health, we are committed to compassionate care that changes lives. The Patient Revenue Management Organization (PRMO) is the fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining scheduling, registration, coding, billing, and other essential revenue functions.
Financial Care Counselor
Work Hours
Commitment Bonus Program $5,000.00 (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.
Work Performed
Analyze insurance coverage and benefits to ensure timely services.
Obtain authorizations based on insurance plan contracts and guidelines.
Document billing system.
Provide assistance explaining bills to visitors and patients.
Explain policies and departmental coverage as requested.
Calculate and apply PRMO credit and collection policies.
Collect cash payments appropriately for all patients.
Reconcile third‑party sponsor necessities and process patients according to reimbursement.
Obtain prior authorization certifications as appropriate.
Facilitate payment sources for uninsured patients.
Determine if a patient's condition is the result of an accident and research to determine appropriate liability/payment source.
Admit, register, and pre‑register patients with accurate demographic and financial data.
Resolve insurance claim rejections/denials and remedy expediently.
Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy.
Perform duties necessary to ensure accounts are processed accurately and efficiently.
Compile departmental statistics for budgetary and reporting purposes.
Assist financially responsible persons in arranging payment.
Make referral for financial counseling.
Determine policy and procedure.
Examine insurance policies and other third‑party sponsorship materials for payment sources.
Inform attending physician of patient financial hardship.
Complete managed care waiver form for patients considered out of network.
Update billing system to reflect insurance status.
Refer patients to Manufacturer Drug program as needed for medications.
Greet patients and resolve problems.
Gather necessary documentation to support inquiry and complaints.
Assist according to policy and procedure.
Enter and update referrals as required.
Communicate with insurance carriers regarding clinical information and resolve 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 that is accurately generated in accordance with established business processes or regulations.
Requires working knowledge of compliance principles; allows the opportunity to work independently.
Minimum Qualifications
Education
Basic grammar and mathematical principles normally required through a high school education; post‑secondary education preferred.
Experience
Two years experience 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 bachelor’s degree and one year of experience working with the public.
Degrees, Licensures and Certifications
None required.
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.
Duke is an 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 (including pregnancy and pregnancy‑related conditions), sexual orientation or military 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 flourish. 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.
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Financial Care Counselor
Work Hours
Commitment Bonus Program $5,000.00 (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.
Work Performed
Analyze insurance coverage and benefits to ensure timely services.
Obtain authorizations based on insurance plan contracts and guidelines.
Document billing system.
Provide assistance explaining bills to visitors and patients.
Explain policies and departmental coverage as requested.
Calculate and apply PRMO credit and collection policies.
Collect cash payments appropriately for all patients.
Reconcile third‑party sponsor necessities and process patients according to reimbursement.
Obtain prior authorization certifications as appropriate.
Facilitate payment sources for uninsured patients.
Determine if a patient's condition is the result of an accident and research to determine appropriate liability/payment source.
Admit, register, and pre‑register patients with accurate demographic and financial data.
Resolve insurance claim rejections/denials and remedy expediently.
Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy.
Perform duties necessary to ensure accounts are processed accurately and efficiently.
Compile departmental statistics for budgetary and reporting purposes.
Assist financially responsible persons in arranging payment.
Make referral for financial counseling.
Determine policy and procedure.
Examine insurance policies and other third‑party sponsorship materials for payment sources.
Inform attending physician of patient financial hardship.
Complete managed care waiver form for patients considered out of network.
Update billing system to reflect insurance status.
Refer patients to Manufacturer Drug program as needed for medications.
Greet patients and resolve problems.
Gather necessary documentation to support inquiry and complaints.
Assist according to policy and procedure.
Enter and update referrals as required.
Communicate with insurance carriers regarding clinical information and resolve 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 that is accurately generated in accordance with established business processes or regulations.
Requires working knowledge of compliance principles; allows the opportunity to work independently.
Minimum Qualifications
Education
Basic grammar and mathematical principles normally required through a high school education; post‑secondary education preferred.
Experience
Two years experience 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 bachelor’s degree and one year of experience working with the public.
Degrees, Licensures and Certifications
None required.
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.
Duke is an 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 (including pregnancy and pregnancy‑related conditions), sexual orientation or military 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 flourish. 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.
#J-18808-Ljbffr