Financial Care Counselor - DRAH Outpatient Service Access; Float Position - Southwest Region

Overview

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.

Patient Revenue Management Organization

Pursue your passion for caring with the Patient Revenue Management Organization, which is the 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 for Duke Health.

Duke Raleigh Outpatient Service

Financial Care Counselor

Wake County Float position covering Southwest Region

Work hours: Monday - Friday (8 hr. shift) Hours ranging from 5:45am to 7:00pm

*** DUHS Commitment Bonus Program $5000.00 (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.

Southwest Region coverage locations:

• DRAH Apex PT/OT
• DRAH Holly Springs PT/OT/Lab
• SRAH Cary (Green Level) PT/OT Outpatient
• DRAH DCI Cary Heme ONC INF Lab
• DRAH DCI Cary CT/RAD/ONC Duke Cancer Center Cary, Radiation Oncology
• DRAH DCI Duke Cancer Center Institute - Macon Pond
• Duke Cardiology of Cary
• Duke Orthopaedics of Apex
• Duke Women's Health Cary (Formerly Green Level)
• Duke Perinatal Consultants of Cary
• Duke Medicine Specialties Cary (Pulmonary)
• Duke Medicine Specialties Cary (Aesthetics, Endocrinology, Hematology, Otolaryngology, Rheumatology)
• Duke Medicine Specialties Cary (Allergy, Gastroenterology, Cardiology, Infusion)
• Duke Medicine Specialties Cary (Neurology, Sports Medicine and Orthopaedics)

Additional regions may be added as additional clinic locations are opened and acquired.
The Duke Raleigh hospital campus is central and considered the main hub for all regions.

Duke University Health System - Patient Revenue Management Office (PRMO) seeks to hire a Financial Care Counselor who will embrace our mission of Advancing Health Together.

Responsibilities

Accurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to pre-admission, admission, pre-registration and registration functions.

Ensure all insurance requirements are met prior to patients' arrival and inform patients of their financial liability prior to arrival for services. Arrange payment options with the patients and screens patients for government funding sources.

• Analyze insurance coverage and benefits for service to ensure timely processing.
• Obtain authorizations based on insurance plan contracts and guidelines.
• Document billing system.
• Explain bills and provide assistance to visitors and patients.
• Explain policies and departmental coverage as requested.
• Calculate and apply according to PRMO credit and collection policies.
• Implement appropriate collect cash payments for all patients.
• Reconcile daily necessity of third party sponsorship and process patients in accordance with reimbursement guidelines.
• Obtain all Prior Authorization Certification and/or authorizations as appropriate.
• Facilitate payment sources for uninsured patients.
• Determine if 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.
• Collect on accounts and assist financially responsible persons in arranging payment.
• Make referrals for financial counseling.
• Determine with policy and procedure.
• Examine insurance policies and other third party sponsorship materials for sources of payment.
• Inform attending physician of patient 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 assist with procedures, and resolve problems.
• Gather necessary documentation to support proper handling of inquiries and complaints.
• Enter and update referrals as required.
• Communicate with insurance carriers regarding clinical information requested and resolve issues relating to coverage.

• Excellent communication skills, oral and written.
• Ability to analyze relationships with patients, physicians, co-workers and supervisors, manage data, perform multiple tasks and work independently.
• Must be able to develop and maintain professional,…