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Financial Care Counselor - DRAH (Midtown)

PRMO Full Time Raleigh, North Carolina
Requisition Number: 244468
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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.

About Duke Health's Patient Revenue Management Organization

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

Duke Raleigh Midtown Specialty Rehab

Financial Care Counselor

Work hours:Mon/Wed/Fri - 9:00am - 5:30pm; Tues/Thurs - 8:30am -  5:00pm.  Hours of availability: 6:30am - 5:30pm

*** 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.

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.

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.

Work Performed

  • Analyze insurance coverage and benefits for service to ensure timely.
  • Obtain authorizations based payment on insurance plan contracts and guidelines.
  • Document billing system.
  • Explain bills provides assistance to visitors and patients.
  • Explain policies and departmental coverage as requested.
  • Calculate and according to PRMO credit and collection policies.
  • Implement appropriate collect cash payments appropriately for all patients.
  • Reconcile daily necessity of third party sponsorship and process patients in accordance reimbursement.
  • 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.
  • Collection actions and assist financially responsible persons in arranging payment.
  • Make referral 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 procedures, and resolves problems.
  • Gathers necessary documentation to support proper handling of inquiries and complaints.
  • Assist with according to policy and procedure.
  • Enter and update referrals as required.
  • Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage

Knowledge, Skills and Abilities

  • Excellent communication skills, oral and written.
  • Ability to analyze relationships with patients, physicians, co-workers and supervisors. data, perform multiple tasks and work independently.
  • Must be able to develop and maintain professional, service-oriented working, 
  • Must be able to understand and comply with policies and procedures.

Level Characteristics

  • 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.

MINIMUM QUALIFICATIONS

Education

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.

Experience

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

None required

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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Explore Patient Revenue Management Organization

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Serving With Purpose

You’ve always been called to care – and we share your dedication to making a meaningful difference in the community. With the entire team united through this purpose, there are no limits to what we can achieve together. You’ll have all the resources you need here to leave a legacy of exceptional service because at Duke Health we support you in your calling to care.

Awards and Recognition

Duke Health is consistently recognized as a top employer for our dedication to the team members and the patients we serve.

Forbes list

On Forbes list of Best Large Employers, we are the #1 healthcare recipient in North Carolina for 2023.

LGBTQ Recognition

Our hospitals are consistently recognized as LGBTQ Healthcare Equality Leaders by Healthcare Equality Index.

Magnet Recognition

We are among about 9 percent of U.S. hospitals that hold the American Nurses Credentialing Center’s Magnet Recognition honor.

CHIME Digital Health

CHIME Digital Health Most Wired recipient since 2018, honoring our ability to elevate the health and care of communities around the world.

Magnet Recognition
We are proud to be named a top healthcare system in North Carolina on Fortune’s 2024 list of America’s Most Innovative Companies.

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