Financial Care Counselor - Speech Pathology & Audiology

Financial Care Counselor - Speech Pathology & Audiology

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The Patient Revenue Management Organization (PRMO) is Duke Health’s fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining revenue activities, including scheduling, registration, coding, billing, and other essential functions.

Accurately complete patient accounts based on departmental protocol, policies, and procedures, and in compliance with regulatory agencies. Ensure insurance requirements are met before patients arrive and inform patients of their financial liability prior to arrival for services. Arrange payment options, screen patients for government funding sources, and facilitate payment sources for uninsured patients.

• Analyze insurance coverage and benefits to ensure timely reimbursement.
• Obtain Prior Authorization Certification and authorizations as appropriate.
• Determine liability sources and research accident-related conditions.
• Admit, register, and pre-register patients with accurate demographic and financial data.
• Resolve insurance claim rejections/denials and remedy them promptly.
• Calculate and collect cash payments for all patients and reconcile daily deposits.
• Evaluate diagnoses for compliance with the Local Medicare Review Policy.
• Compile departmental statistics for budgetary and reporting purposes.
• Explain bills according to PRMO credit and collection policies.
• Implement appropriate collection actions and assist patients in arranging payment.
• Make referrals for financial counseling and sponsor insurance investigations.
• Inform attending physicians of patient financial hardship.
• Complete stored care waiver forms for patients out of network and receiving reduced benefits.
• Update the billing system to reflect patient insurance status.
• Refer patients to the Manufacturer Drug program as needed.
• Provide assistance to visitors and patients, explaining policies and procedures and resolving problems.
• Gather necessary documentation to support inquiries and complaints.
• Assist with departmental coverage as requested.
• Obtain authorizations based on insurance contracts and guidelines.
• Document billing system updates according to policy and procedure.
• Enter and update referrals as required.
• Communicate with insurance carriers regarding coverage and payment issues.

• Excellent oral and written communication skills.
• Ability to analyze data and perform multiple tasks independently.
• Ability to maintain professional, service-oriented relationships with patients, physicians, co-workers, and supervisors.
• Understanding and compliance with policies and procedures.

Position responsible for high production generated accurately in accordance with established business processes or regulation. Requires working knowledge of compliance principles. Job allows the opportunity to work independently.

• High‑school education required; postsecondary education preferred.

• Two years’ experience in hospital service access, clinical service access, physician office or billing & collections.
• Or an associate’s degree in a healthcare related field and one year of public-facing experience.
• Or a bachelor’s degree and one year of public-facing experience.

None required.

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.

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.