Financial Care Counselor - Cardiopulmonary Rehab
Duke University Health System, Durham, NC, United States
Financial Care Counselor – Patient Revenue Management Office (PRMO)
The Financial Care Counselor will accurately complete patient accounts, ensure insurance compliance, inform patients of financial liability, arrange payment options, and facilitate financial counseling.
Work Hours & Compensation
DUHS Commitment Bonus Program: $5,000.00 (paid in 2 installments over 12 months – 6 month increments). Eligibility restricted to new hires who have not worked for Duke University in the past 12 months.
Responsibilities
Analyze insurance coverage and benefits for timely service.
Obtain authorizations and payment based on insurance plan contracts and guidelines.
Document billing system and explain bills to patients.
Explain policies and departmental coverage as requested.
Calculate and apply PRMO credit and collection policies.
Appropriately collect cash payments for all patients.
Reconcile third‑party sponsorship and process patients in accordance with reimbursement procedures.
Obtain Prior Authorization Certification and authorizations as appropriate.
Facilitate payment sources for uninsured patients.
Determine if patient's condition is the result of an accident and perform research to determine appropriate liability/payment source.
Admit, register and pre‑register patients with accurate demographic and financial data.
Resolve insurance claim rejections/denials expediently.
Evaluate diagnoses to ensure compliance with Local Medicare Review Policy.
Ensure all accounts are processed accurately and efficiently.
Compile departmental statistics for budgetary and reporting purposes.
Assist financially responsible persons in arranging payment.
Make referrals for financial counseling.
Determine eligibility with policy and procedure.
Examine insurance policies and other third‑party sponsorship materials for sources of payment.
Inform attending physicians of patient financial hardship.
Complete managed‑care waiver form for out‑of‑network patients receiving services at a reduced benefit level.
Update billing system to reflect insurance status of the patient.
Refer patients to Manufacturer Drug Program as needed.
Greet patients, review procedures, and resolve problems.
Gather documents to support inquiry and complaint handling.
Assist in accordance with 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 independently.
Professional, service‑oriented approach.
Understand and comply with policies and procedures.
Level Characteristics
Responsible for high production generated accurately per established business processes or regulations.
Requires working knowledge of compliance principles; works independently.
Minimum Qualifications
Education:
High school education required; postsecondary education preferred; training or knowledge of related business acceptable.
Experience:
Two years in hospital service access, clinical service access, physician office, billing and collections; or Associate’s degree in a healthcare related field and one year experience with the public; or Bachelor’s degree and one year experience with the public.
Degrees, Licensures, Certifications:
None required.
Equal Employment Opportunity Statement
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.
Essential Physical Job Functions
Certain jobs may require specific physical and/or mental abilities. Additional information and accommodation requests will be provided by the hiring department.
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The Financial Care Counselor will accurately complete patient accounts, ensure insurance compliance, inform patients of financial liability, arrange payment options, and facilitate financial counseling.
Work Hours & Compensation
DUHS Commitment Bonus Program: $5,000.00 (paid in 2 installments over 12 months – 6 month increments). Eligibility restricted to new hires who have not worked for Duke University in the past 12 months.
Responsibilities
Analyze insurance coverage and benefits for timely service.
Obtain authorizations and payment based on insurance plan contracts and guidelines.
Document billing system and explain bills to patients.
Explain policies and departmental coverage as requested.
Calculate and apply PRMO credit and collection policies.
Appropriately collect cash payments for all patients.
Reconcile third‑party sponsorship and process patients in accordance with reimbursement procedures.
Obtain Prior Authorization Certification and authorizations as appropriate.
Facilitate payment sources for uninsured patients.
Determine if patient's condition is the result of an accident and perform research to determine appropriate liability/payment source.
Admit, register and pre‑register patients with accurate demographic and financial data.
Resolve insurance claim rejections/denials expediently.
Evaluate diagnoses to ensure compliance with Local Medicare Review Policy.
Ensure all accounts are processed accurately and efficiently.
Compile departmental statistics for budgetary and reporting purposes.
Assist financially responsible persons in arranging payment.
Make referrals for financial counseling.
Determine eligibility with policy and procedure.
Examine insurance policies and other third‑party sponsorship materials for sources of payment.
Inform attending physicians of patient financial hardship.
Complete managed‑care waiver form for out‑of‑network patients receiving services at a reduced benefit level.
Update billing system to reflect insurance status of the patient.
Refer patients to Manufacturer Drug Program as needed.
Greet patients, review procedures, and resolve problems.
Gather documents to support inquiry and complaint handling.
Assist in accordance with 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 independently.
Professional, service‑oriented approach.
Understand and comply with policies and procedures.
Level Characteristics
Responsible for high production generated accurately per established business processes or regulations.
Requires working knowledge of compliance principles; works independently.
Minimum Qualifications
Education:
High school education required; postsecondary education preferred; training or knowledge of related business acceptable.
Experience:
Two years in hospital service access, clinical service access, physician office, billing and collections; or Associate’s degree in a healthcare related field and one year experience with the public; or Bachelor’s degree and one year experience with the public.
Degrees, Licensures, Certifications:
None required.
Equal Employment Opportunity Statement
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.
Essential Physical Job Functions
Certain jobs may require specific physical and/or mental abilities. Additional information and accommodation requests will be provided by the hiring department.
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