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Financial Services Advisor

2 months ago

Durham, North Carolina, United States Duke University Full time

At Duke Health, our mission is to provide compassionate care that positively impacts the lives of patients, their families, and the broader community.

About Duke HomeCare & Hospice

Explore your passion for caregiving with Duke HomeCare & Hospice, which delivers hospice, home health, and infusion services throughout the region, while also supporting the Duke Caregiver Support Program. Our team collaborates closely with a patient's healthcare provider to ensure comprehensive, personalized care in the comfort of their home or at our inpatient hospice facility.

POSITION SUMMARY

The Financial Care Counselor acts as a case manager and liaison between the patient's insurance provider and all Duke HomeCare & Hospice programs, including Home Health, Hospice, and Infusion services. This role is essential for securing initial authorizations for services provided by Duke HomeCare & Hospice. Should re-authorization be necessary for continued services, the Financial Care Counselor will also be responsible for obtaining the required approvals. This position is crucial in ensuring that our programs receive appropriate compensation for the services rendered when claims are submitted to the insurance provider. The ability to work independently is a key requirement for this role.

POSITION RELATIONS

Reports to: Manager, Business Development

POSITION RESPONSIBILITIES:

  1. Maintains patient confidentiality in accordance with HIPAA regulations.
  2. Secures authorizations based on insurance policy contracts and guidelines.
  3. Documents actions in billing systems following established policies and procedures.
  4. Communicates with insurance providers and Duke HomeCare & Hospice programs regarding clinical information needed to obtain all necessary authorizations.
  5. Addresses issues related to authorization procurement to ensure services can be delivered.
  6. Informs the manager of any concerns regarding authorizations.
  7. Reports any IT-related issues to the manager.
  8. Generates the authorization expiration report in billing systems and alerts programs to determine if further authorization is required.
  9. Completes special projects and additional tasks as assigned.
Required Qualifications at this Level

Education

Knowledge of basic grammar and mathematical principles typically acquired through a high school education, with some postsecondary education preferred. Additional training or experience in a related business field is advantageous.

Experience

Two years of experience in hospital service access, clinical service access, physician office operations, or billing and collections. Alternatively, an Associate's degree in a healthcare-related field with one year of public-facing experience, or a Bachelor's degree with one year of public-facing experience.

Degrees, Licensure, and/or Certification

No specific certifications required.

Knowledge, Skills, and Abilities

Exceptional communication skills, both verbal and written. Ability to analyze data, manage multiple tasks, and work independently. Must be capable of developing and maintaining professional, service-oriented relationships with patients, healthcare providers, colleagues, and supervisors. Must understand and adhere to policies and procedures.

Distinguishing Characteristics of this Level

This position is responsible for high-volume production generated accurately in accordance with established business processes or regulations. Requires a working knowledge of compliance principles. The role offers opportunities for independent work.

Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunities without regard to 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, which is best achieved when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To foster this exchange, it is essential that all community members feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community share the responsibility to uphold these values.

Essential Physical Job Functions: Certain roles at Duke University and Duke University Health System may involve essential job functions that require specific physical and/or mental abilities. Additional information and provisions for requests for reasonable accommodation will be provided by each hiring department.