FINANCIAL CARE COUNSELOR
Duke Health strongly recommends getting up-to-date vaccinations against COVID-19, especially for those with conditions that place them at higher risk. However, COVID-19 vaccination is no longer a requirement for team members at Duke Health.
***$5000.00 Sign On Bonus (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 sign-on bonus.
Accurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulations for patients and screen patients for government funding sources.
Analyze insurance coverage and benefits for agencies, including but not limited to pre-admission, admission, pre-registration, and registration functions. Ensure all insurance requires liability before arrival for services. Arrange payment options w ithts are met before patients' arrival and inform patients of their financial service to ensure timely reimbursement. Obtain all Prior Authorization Certification and/or authorization as appropriate. Facilitate payment sources for uninsured patients. Determine if the 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. Calculate and collect cash payments appropriately for all patients. Reconcile daily cash deposit. Evaluate diagnoses to ensure compliance with the LocalMedicare Review Policy. Perform those duties necessary to ensure all accounts are processed accurately and efficiently. Compile departmental statistics for budgetary and reporting purposes. Explain bills according to PRMO credit and collection policies. Implement appropriate collection actions and assist financially responsible persons in arranging payment. Make a referral for financial counseling. Determine the necessity of third-party sponsorship and process patients by policy and procedure. Examine insurance policies and other third-party sponsorship materials for sources of payment. Inform the attending physician of the patient's 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. Explain policies and procedures, and resolve problems program as needed for medications. Gathers necessary documentation to support proper handling of inquiries and complaints. Assist with departmental coverage as requested. Obtain authorizations based on insurance plan contracts and guidelines. Documentbil ling system according to policy and procedure. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information requested and resolve issues relating to coverage and payment.
Knowledge, Skills, and Abilities
Excellent communication skills, oral and written. Ability to analyze data, perform multiple tasks, and work independently. Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers, and supervisors.Must be able to understand and comply with policies and procedures.
Position responsible for high production generated accurately by es tablished business processes or regulations. Requires working knowledge of compliance principles. The job allows the opportunity to work independently.
Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some postsecondary education preferred. Additional training or working knowledge of related business.
Two years experience working in hospital service access, clinical service access, physician office, or billing and collections. Or, an Associate's degree in a healthcare-related field and one year of experience working with the public. Or, a Bachelor's degree and one year of experience working with the public.
Degrees, Licensures, Certifications
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.
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Duke Health is consistently recognized as a top employer for our dedication to the team members and the patients we serve.
On Forbes list of Best Large Employers, we are the #1 healthcare recipient in North Carolina for 2023.
Our hospitals are consistently recognized as LGBTQ Healthcare Equality Leaders by Healthcare Equality Index.
We are among about 9 percent of U.S. hospitals that hold the American Nurses Credentialing Center’s Magnet Recognition honor.
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We are proud to be named as the #1 healthcare system in North Carolina on Fortune’s America’s Most Innovative Companies 2023 list.
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