Duke University Health System ยท 17 hours ago
FINANCIAL CARE COUNSELOR
Raleigh, NC
Full-time
Onsite
Entry Level
1+ years expDuke University Health System is committed to compassionate care that changes the lives of patients and their families. The Financial Care Counselor role involves managing patient accounts, ensuring compliance with insurance requirements, and facilitating payment options for patients.
Health CareMedical
Responsibilities
Accurately complete patient accounts based on departmental protocol, policies, and procedures, and compliance with regulatory agencies, to include but not be limited to pre-admission, admission, pre-registration, and registration functions
Ensure all insurance requirements are met before patients' arrival and inform patients of their financial liability before arrival for services
Arrange payment options with the patients and screen patients for government funding sources
Analyze insurance coverage and benefits for service to ensure timely reimbursement
Obtain all prior authorization certification and/or authorizations as appropriate
Facilitate payment sources for uninsured patients
Determine if the patient's condition is the result of an accident and perform complete research to determine the appropriate source of liability/payment
Admit, register, and preregister patients with accurate patient demographic and financial data
Resolve insurance claim rejections/denials and remedy them expediently
Calculate and collect cash payments appropriately for all patients
Reconcile the daily cash deposit
Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy
Perform those duties necessary to ensure all accounts are processed accurately and efficiently
Compile departmental statistics for budgetary and reporting purposes
Explain bills according to PRMO credit and collection policies
Implement appropriate collection actions and assist financially responsible persons in arranging payment
Make a referral for financial counseling
Determine the necessity of third-party sponsorship and process patients in accordance with policy and procedure
Examine insurance policies and other third-party sponsorship materials for sources of payment
Inform the attending physician of the patient's financial hardship
Complete the 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 the Manufacturer Drug program as needed for medications
Greet and assist visitors and patients
Explain policies and procedures, and resolve problems
Gathers necessary documentation to support proper handling of inquiries and complaints
Assist with departmental coverage as requested
Obtain authorizations based on insurance plan contracts and guidelines
Document billing system 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 and payment
Qualification
Required
Work requires knowledge of basic grammar and mathematical principles normally required through a high school education
Two years of experience working in hospital service access, clinical service access, a physician's office, or billing and collections
Or, an Associate's degree in a healthcare-related field and one year of experience working with the public
Or, a Bachelor's degree and one year of experience working with the public
Excellent communication skills, oral and written
Ability to analyze data, perform multiple tasks, and work independently
Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, co-workers, and supervisors
Must be able to understand and comply with policies and procedures
Preferred
Some postsecondary education preferred
Additional training or working knowledge of related business
Company
Duke University Health System
World-class academic and health care system
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Chernelle Jones
Special Events Coordinator for: Exec. Vice Pres. Health Affairs, CEO of DUHS, & Dean, School of Med.
Dan Bruno
Chief of Staff and Chief Operating Officer, Duke Health Technology Solutions
Recent News
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2025-11-27
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