Duke University Health System · 2 months ago
Financial Care Counselor-Commitment Bonus
Durham, NC
Full-time
Onsite
Entry Level
1+ years expDuke University Health System is dedicated to compassionate care that impacts patients and their communities. The Financial Care Counselor role involves analyzing insurance coverage, assisting patients with financial inquiries, and ensuring compliance with billing and collection policies.
Health CareMedical
Responsibilities
Ability to analyze insurance coverage and benefits for service to ensure timely obtain authorizations based on established payment relationships with patients, physicians, co-workers, and supervisors
Position responsible for high production, generating accurately in Accurately complete patient accounts based on departmental protocol, greeting and assisting visitors and patients
Explain policies and calculate according to PRMO credit and collection policies
Implement appropriate work independently
Must be able to develop and maintain professional relationships and comply with policies and procedures on insurance plan contracts and guidelines
Document billing system
Explain bills business processes, or regulations
Requires working knowledge of uninsured patients
Determine if the patient's condition is the result of research to determine the appropriate source of liability/payment, according to policy and sources
Coverage and clinical information are requested to resolve issues relating to facilitating payment sources for authorization, certification, and/or authorizations as appropriate
Compliance with regulatory agencies, including but not limited to insurance claim departmental policies, and collecting cash payments appropriately for all patients
Reconcile daily the opportunity to work independently
Patients with accurate patient demographics and financial data
Resolve registration and registration functions
Ensure all insurance arrangements are made and inform patients of their financial liability before discussing options with the patients and screen patients for government funding, working procedures, and pre-admission, admission, and pre-requirements before the patients' arrival for services
Arrange payment reimbursement
Obtain all prior accidents and perform complete admission, register, and preregister rejections/denials, and remedy expediently cash deposits
Evaluated diagnoses to ensure compliance with the Local Medicare Review Policy
Perform those duties
Compile statistics for budgetary and reporting purposes
Collection is necessary to ensure all accounts are processed accurately and efficiently, and to 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 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
Procedures and resolves problems
Gathers necessary documentation to support proper handling of inquiries and complaints
Assist with departmental coverage as requested
Enter and update referrals as required
Communicate with insurance carriers regarding data, perform multiple tasks, and be service-oriented
Must be able to understand and comply with principles
The job allows working in an Emergency Department environment
Qualification
Required
Ability to analyze insurance coverage and benefits for service to ensure timely obtain authorizations based on established payment relationships with patients, physicians, co-workers, and supervisors
Position responsible for high production, generating accurately in Accurately complete patient accounts based on departmental protocol, greeting and assisting visitors and patients
Explain policies and calculate according to PRMO credit and collection policies
Implement appropriate work independently
Must be able to develop and maintain professional relationships and comply with policies and procedures on insurance plan contracts and guidelines
Document billing system
Explain bills business processes, or regulations
Requires working knowledge of uninsured patients
Determine if the patient's condition is the result of research to determine the appropriate source of liability/payment, according to policy and sources
Coverage and clinical information are requested to resolve issues relating to facilitating payment sources for authorization, certification, and/or authorizations as appropriate
Compliance with regulatory agencies, including but not limited to insurance claim departmental policies, and collecting cash payments appropriately for all patients
Reconcile daily the opportunity to work independently
Patients with accurate patient demographics and financial data
Resolve registration and registration functions
Ensure all insurance arrangements are made and inform patients of their financial liability before discussing options with the patients
Screen patients for government funding, working procedures, and pre-admission, admission, and pre-requirements before the patients' arrival for services
Arrange payment reimbursement
Obtain all prior accidents and perform complete admission, register, and preregister rejections/denials, and remedy expediently cash deposits
Evaluated diagnoses to ensure compliance with the Local Medicare Review Policy
Perform those duties
Compile statistics for budgetary and reporting purposes
Collection is necessary to ensure all accounts are processed accurately and efficiently, and to 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 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
Procedures and resolves problems
Gathers necessary documentation to support proper handling of inquiries and complaints
Assist with departmental coverage as requested
Enter and update referrals as required
Communicate with insurance carriers regarding data, perform multiple tasks, and be service-oriented
Must be able to understand and comply with principles
The job allows working in an Emergency Department environment
Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some postsecondary education preferred
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
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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