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Financial Care Counselor

3 months 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 HomeCare & Hospice

Pursue your passion for caring with Duke HomeCare & Hospice, which offers hospice, home health, and infusion services across the region, as well as serves as the home forthe Duke Caregiver Support Program. Team members work closely with a patient's physician to provide comprehensive, individualized care in the comfort of their home or at our inpatient hospice facility in Durham, NC.

POSITION SUMMARY

Case Manager/liaison between the patient's payer source and all DHCH programs-Home Health, Hospice and Infusion. The Financial Care Counselor's role is to obtain the initial authorization for services being rendered by the DHCH programs. If re-authorization is required, in order for services to be continued, the Financial Care Counselor is involved in obtaining the additional authorization as well. This position plays a critical role in helping to ensure that DHCH programs will receive payment for the services they are performing when claims are filed to the payer source. This position must be able to work independently.

POSITION RELATIONS

Responsible to: Manager, Business Development

POSITION RESPONSIBILITIES:

  1. Ensures confidentiality of patient information through HIPAA Compliance.
  2. Obtains authorizations based on insurance plan contracts and guidelines.
  3. Documents in billing systems according to policy and procedure.
  4. Communicates with payer sources and DHCH programs regarding clinical information requested, in order to obtain all authorizations.
  5. Resolves issues related to obtaining authorizations from payer sources, so services can be rendered.
  6. Notifies manager of any authorization concerns.
  7. Communicates to manager any IT issues.
  8. Runs the authorization expiration report in billing systems, and notifies the programs they need to determine if additional authorization is going to be needed.
  9. Performs special projects as assigned and other duties as requested.


Required Qualifications at this Level

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, Licensure, and/or Certification

None required

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.

Distinguishing Characteristics of this Level

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.

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.