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Patient Financial Advisor

2 months ago

Durham, North Carolina, United States Duke University Full time

About Duke University Health System

Established in 2001, the Patient Revenue Management Organization (PRMO) is a comprehensive, centralized revenue cycle entity that supports the entire Duke Health network. Our focus is on optimizing the revenue cycle through improved management of scheduling, registration, coding, health information management, billing, collections, cash flow, and customer service. Our mission is to deliver exceptional service by enhancing the patient experience, ensuring financial stability, and upholding Duke's commitment to advancing health collaboratively.

Position Overview: Financial Care Counselor

Work Hours:

*** Commitment Bonus Program available for eligible new hires ***

The Duke University Health System's Patient Revenue Management Office (PRMO) is seeking a dedicated Financial Care Counselor who aligns with our mission of Advancing Health Together.

Key Responsibilities:

  • Accurately manage patient accounts in accordance with departmental protocols and compliance standards.
  • Ensure all insurance prerequisites are fulfilled before patient appointments and communicate financial responsibilities to patients beforehand.
  • Facilitate payment arrangements and assess patients for potential government funding options.
  • Conduct thorough analyses of insurance coverage and benefits to guarantee timely service delivery.
  • Secure necessary authorizations based on insurance agreements and guidelines.
  • Maintain accurate documentation within the billing system.
  • Provide clear explanations of bills and assist patients and visitors with inquiries.
  • Calculate financial obligations in line with PRMO credit and collection policies.
  • Implement appropriate cash collection strategies for all patients.
  • Reconcile daily third-party sponsorships and process patient accounts in accordance with reimbursement protocols.
  • Obtain prior authorizations as required.
  • Assist uninsured patients in identifying payment sources.
  • Investigate if a patient's condition stems from an accident and identify the appropriate liability/payment source.
  • Accurately admit, register, and pre-register patients with correct demographic and financial information.
  • Resolve insurance claim denials and rejections promptly.
  • Evaluate diagnoses to ensure adherence to Local Medicare Review Policies.
  • Perform essential duties to guarantee accurate and efficient account processing.
  • Compile departmental statistics for budgetary and reporting needs.
  • Assist financially responsible individuals in arranging payment plans.
  • Make referrals for financial counseling as necessary.
  • Review insurance policies and third-party sponsorship documents for payment sources.
  • Inform the attending physician of any patient financial hardships.
  • Complete managed care waiver forms for out-of-network patients receiving reduced benefits.
  • Update the billing system to reflect the patient's insurance status.
  • Refer patients to manufacturer drug programs for medication assistance.
  • Welcome patients and address any procedural issues or concerns.
  • Gather necessary documentation to support inquiries and complaints.
  • Assist with referrals as per policy and procedure.
  • Communicate with insurance carriers regarding requested clinical information and resolve coverage issues.
Knowledge, Skills, and Abilities:
  • Exceptional oral and written communication skills.
  • Ability to analyze relationships with patients, physicians, colleagues, and supervisors.
  • Capability to manage multiple tasks independently while maintaining a professional, service-oriented demeanor.
  • Understanding and compliance with established policies and procedures.
Qualifications:

Education:
High school education with knowledge of basic grammar and mathematics; postsecondary education preferred. Additional training or experience in a related business field is advantageous.

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

Certifications:
No specific certifications required.

Duke University 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. We strive to create a collaborative, innovative, and inclusive community where diverse perspectives and experiences are valued.