Patient Financial Advocate

3 weeks ago


Durham, North Carolina, United States Duke Health Full time

At Duke Health, our mission is to deliver compassionate care that changes lives. We're seeking a highly skilled Patient Financial Advocate to join our team.

About the Role

This role will be responsible for ensuring accurate and efficient processing of patient accounts, while providing excellent customer service to patients and their families. As a Patient Financial Advocate, you will work closely with healthcare providers, insurance companies, and government agencies to resolve financial issues and ensure timely payment for medical services.

Responsibilities

  • Analyze insurance coverage and benefits to ensure timely payment for services
  • Obtain authorizations based on insurance plan contracts and guidelines
  • Document billing system accurately and efficiently
  • Explain bills and provide assistance to visitors and patients
  • Explain policies and departmental coverage as requested
  • Calculate and apply PRMO credit and collection policies
  • Implement appropriate collect cash payments for all patients
  • Reconcile daily necessity of third-party sponsorship and process patients in accordance with reimbursement
  • Obtain all Prior Authorization Certification and/or authorizations as appropriate
  • Facilitate payment sources for uninsured patients
  • Determine if patient's condition is the result of an accident and perform complete research to determine the appropriate source of liability/payment
  • Admit, register, and pre-register patients with accurate patient demographic and financial data
  • Resolve insurance claim rejections/denials and remedy expediently
  • Evaluate diagnoses to ensure compliance with Local Medicare Review Policy
  • Perform duties necessary to ensure all accounts are processed accurately and efficiently
  • Compile departmental statistics for budgetary and reporting purposes
  • Collection actions and assist financially responsible persons in arranging payment
  • Make referrals for financial counseling
  • Determine compliance with policy and procedure
  • Examine insurance policies and other third-party sponsorship materials for sources of payment
  • Inform attending physician of patient financial hardship
  • Complete managed care waiver form for patients considered out of network and receiving services at a reduced benefit level
  • Update the billing system to reflect the insurance status of the patient
  • Refer patients to Manufacturer Drug program as needed for medications
  • Greet and procedures, and resolves problems
  • Gather necessary documentation to support proper handling of inquiries and complaints
  • Assist with according to policy and procedure
  • Enter and update referrals as required
  • Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage

Requirements

  • Excellent communication skills, oral and written
  • Ability to analyze relationships with patients, physicians, co-workers, and supervisors
  • Must be able to develop and maintain professional, service-oriented working relationships
  • Must be able to understand and comply with policies and procedures

Estimated Salary Range

$45,000 - $60,000 per year, depending on experience and qualifications.

Why Choose Us?

Duke Health offers a comprehensive benefits package, including medical, dental, and vision insurance, 401(k) matching, and paid time off. Our organization values diversity, equity, and inclusion and strives to create a workplace culture that is welcoming and inclusive for all employees.



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