Patient Financial Services Representative

2 weeks ago

Durham, North Carolina, United States Duke University Health System Full time

Join Duke University Health System in our mission to provide exceptional care that transforms the lives of patients and their families. Our organization is dedicated to advancing health through compassionate service and innovative solutions.

About the Patient Revenue Management Organization

Become a part of our fully integrated revenue cycle team, which plays a crucial role in optimizing the financial operations of our health system. This encompasses vital functions such as scheduling, registration, coding, billing, and other key revenue processes.

Position Overview

This is an ONSITE role with a schedule of Monday to Friday, from 7:30 AM to 4:00 PM.

Key Responsibilities

  1. Accurately manage patient accounts in accordance with departmental protocols and regulatory compliance.
  2. Ensure all insurance prerequisites are fulfilled prior to patient visits and communicate financial responsibilities to patients ahead of their appointments.
  3. Facilitate payment arrangements and assess eligibility for government funding programs.
  4. Analyze insurance benefits to guarantee prompt reimbursement for services rendered.
  5. Obtain necessary prior authorizations and assist uninsured patients in exploring payment options.
  6. Conduct thorough investigations to identify liability sources for patients involved in accidents.
  7. Register and pre-register patients with precise demographic and financial information.
  8. Address and resolve insurance claim denials efficiently.
  9. Calculate and collect cash payments from patients accurately.
  10. Reconcile daily cash deposits and compile departmental statistics for reporting and budgeting.
  11. Provide clear explanations of billing in line with credit and collection policies.
  12. Implement appropriate collection strategies and assist patients in arranging payments.
  13. Make referrals for financial counseling when necessary.
  14. Assess the need for third-party sponsorship and process patients accordingly.
  15. Review insurance policies to identify potential payment sources.
  16. Communicate patient financial hardships to attending physicians.
  17. Complete necessary documentation for managed care waivers for out-of-network services.
  18. Update billing systems to reflect the current insurance status of patients.
  19. Guide patients towards manufacturer drug programs for medication assistance.
  20. Welcome and assist visitors and patients, addressing inquiries and resolving issues.
  21. Gather documentation to support effective handling of complaints and inquiries.
  22. Assist with departmental coverage as needed.
  23. Document billing processes in accordance with established policies.
  24. Maintain communication with insurance carriers to resolve coverage and payment issues.

Qualifications

Knowledge, Skills, and Abilities: Excellent verbal and written communication skills, ability to analyze data, manage multiple tasks, and work independently. Must foster professional relationships with patients, healthcare providers, and colleagues while adhering to policies and procedures.

Minimum Requirements:

Education: High school diploma 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, 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.

Licensure/Certification: None required.

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