Financial Care Counselor

3 weeks ago

Durham, United States Duke University Full time

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 Dermatology (Dawson Hall)

Financial Care Counselor

Work hours:Monday - Friday 8:00a - 4:30p

*** 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.

OCC SUMMARY

HOURS: 8:00am - 4:30pm - Chapel Hill, NC. This position supports 11 providers at Dawson Hall Dermatology for medical and cosmetic visits. Accurately update patient accounts based on policies. Implement appropriate collection actions for financially responsible persons in arranging payments. Review referrals for finance and reporting purposes. Explain bills according to PRMO policies and procedures. Examine insurance policies and other third-party materials for sources of payments. Determine clinical protocols and policies/ procedures updating appointments to determine registration and payment needs. Ensure all insurance requirements are met prior to patients' arrival, informing patients of their financial liability prior to arrival for services. Arrange payment options with the patients and screen patients for government funding sources, if applicable.

WORK PERFORMED

Analyze insurance coverage/ benefits for service to ensure timely reimbursement. Obtain all Prior Authorizations as directed by appropriate procedures, for in and out of network Patient insurance plan contracts and benefit guidelines. Document referral authorization details as required for insurance coverage. Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage and payment. Update Patient records with details for claim submissions. Facilitate payment sources for uninsured patients. Admit, register and pre-register patients with accurate demographic and financial data. Update Patient appointments to reflect current insurance status. Timely review claim rejections/ denials to resolve prior to patients' next appointment; Calculate/ collect cash payments appropriately for all patients; Notify patients of self-pay balances and collect, to ensure all accounts are processed accurately and efficiently. Complete the managed Care-waiver Form, for patients considered Out-of-Network for services at a reduced benefit level. When appropriate, counsel patients to explain policies and procedures to resolve payment/authorization inquires. Gather necessary documentation for proper handling of patient inquiries and complaints. Communicate with insurance carriers regarding clinical information requests to resolve issues relating to coverage and claim payments. May require floating to other dermatology clinics for administrative coverage support, as needed.

KNOWLEDGE, SKILLS AND ABILITIES

Excellent communication skills, oral and written. Ability to understand and analyze patient guarantor account data, to determine patients' financial history of dermatology clinic visits, perform multiple tasks and work independently. Ability to communicate and collect patient past due balances from dermatology visits. 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.

LEVEL CHARACTERISTICS

Position responsible for high production generated accurately in accordance with established business processes or regulation. Requires working knowledge of compliance principles, and strong time management skills, to review/complete updates prior to patients' appointment dates. Job allows the opportunity to work independently, but required to work at front desk, as needed by SAM.

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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