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Financial Care Specialist

2 months ago

Durham, North Carolina, United States Duke University Full time
About the Role

We are seeking a highly skilled and detail-oriented Financial Care Specialist to join our Patient Revenue Management Organization at Duke University Health System.

Key Responsibilities
  • Analyze patient insurance coverage and benefits to ensure timely and accurate billing.
  • Obtain authorizations and process payments in accordance with insurance plan contracts and guidelines.
  • Document and maintain accurate billing records.
  • Explain billing and payment procedures to patients and their families.
  • Calculate and apply credits and collections in accordance with PRMO policies.
  • Implement cash payment options and reconcile daily transactions.
  • Process prior authorization certifications and authorizations as required.
  • Facilitate payment arrangements for uninsured patients.
  • Determine liability and payment sources for patients with accident-related conditions.
  • Admit, register, and pre-register patients with accurate demographic and financial data.
  • Resolve insurance claim rejections and denials in a timely manner.
  • Evaluate diagnoses to ensure compliance with Local Medicare Review Policy.
  • Perform other duties as necessary to ensure accurate and efficient account processing.
  • Compile departmental statistics for budgetary and reporting purposes.
  • Collect payments and assist financially responsible individuals in arranging payment plans.
  • Refer patients to financial counseling services as needed.
Requirements
  • Excellent communication and analytical skills.
  • Ability to work independently and as part of a team.
  • Knowledge of compliance principles and regulatory requirements.
  • High school diploma or equivalent required; postsecondary education preferred.
  • Two years of experience in hospital service access, clinical service access, physician office, or billing and collections.
  • Associate's degree in a healthcare-related field and one year of experience working with the public.
  • Bachelor's degree and one year of experience working with the public.
What We Offer

Duke University Health System is committed to providing a comprehensive benefits package that includes competitive salaries, excellent health insurance, and retirement plans.