Financial Care Counselor
Duke Careers
full-time
Posted on:
Location Type: Office
Location: Wake Forest • North Carolina • 🇺🇸 United States
Visit company websiteJob Level
JuniorMid-Level
About the role
- Accurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies, to include but not limited to pre-admission, admission, pre-registration and registration functions.
- Ensure all insurance requirements are met prior to patients' arrival and inform patients of their financial liability prior to arrival for services.
- Arrange payment options with the patients and screens patients for government funding sources.
- Analyze insurance coverage and benefits for service to ensure timely.
- Obtain authorizations based payment on insurance plan contracts and guidelines.
- Document billing system.
- Explain bills provides assistance to visitors and patients.
- Explain policies and departmental coverage as requested.
- Calculate and according to PRMO credit and collection policies.
- Implement appropriate collect cash payments appropriately for all patients.
- Reconcile daily necessity of third party sponsorship and process patients in accordance 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 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.
- Collection actions and assist financially responsible persons in arranging payment.
- Make referral for financial counseling.
- Determine 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 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 procedures, and resolves problems. Gathers 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
- Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some postsecondary education preferred.
- Two years experience working in hospital service access, clinical service access, physician office or billing and collections.
- An Associate's degree in a healthcare related field and one year of experience working with the public.
- A Bachelor's degree and one year of experience working with the public.
- None required.
Benefits
- DUHS Commitment Bonus Program $5000.00 (paid in 2 installments over 12 months - 6 month increments)
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
billing systeminsurance coverage analysisauthorizationspayment processingfinancial counselingdata reconciliationstatistical reportingclaims resolutionpatient registrationmedical coding
Soft skills
communicationproblem-solvinginterpersonal skillsorganizational skillscustomer serviceattention to detailanalytical thinkingconflict resolutionfinancial negotiationcollaboration
Certifications
Associate's degree in healthcareBachelor's degree