FINANCIAL CARE COUNSELOR - DUKE SPECIALTY REHAB SERVICES MIDTOWN
Duke University Health System
Location: Durham, North Carolina
Admin / Clerical
Internal Number: 197019
PRMO Established in 2001, Patient Revenue Management Organization (PRMO) is a fully integrated, centralized revenue cycle organization supporting all of Duke Health, including Duke University Hospital, Duke Regional Hospital, Duke Raleigh Hospital, the Private Diagnostic Clinic, and Duke Primary Care. The PRMO focuses on streamlining the revenue cycle through enhanced management of scheduling, registration, coding, HIM operations, billing, collections, cash management, and customer service. The Mission of the PRMO is delivering quality service by enhancing the patient experience, providing financial security, and preserving Dukeâ€™s reputation and mission of advancing health together. Our Vision is to be recognized as a world class innovative revenue cycle organization that values our people, patients and performance.
Location: Duke Raleigh Midtown Specialty Rehab
Hour s: Mon/Wed/Fri-(9:00am-5:30pm);Tues/Thurs(8:30am-5:00pm) Hours of avail ability: 6:30am-5:30pm
Accurately complete patient accounts based on departmental protocol,policies and pr ocedures, and compliance with regulatory agencies, toinclude but not lim ited to pre-admission, admission, pre-registrationand registration funct ions. Ensure all insurance requirements are metprior to patients' arriva l and inform patients of their financialliability prior to arrival for s ervices. Arrange payment options withthe patients and screens patients f or government funding sources.
Analyz e insurance coverage and benefits for service to ensure timelyreimbursem ent. Obtain all Prior Authorization Certification and/orauthorizations a s appropriate. Facilitate payment sources for uninsuredpatients. Determi ne if patient's condition is the result of an accidentand perform comple te research to determine the appropriate source ofliability/payment. Adm it, register and pre-register patients withaccurate patientdemographic and financial data. Resolve insuranceclaim rejections/denials and remedy expediently.Calculate andcollect cash payments appropriately for all pa tients. Reconcile dailycash deposit. Evaluate diagnoses to ensure compli ance with the LocalMedicare Review Policy. Perform those duties necessar y to ensure allaccounts are processed accurately and efficiently. Compile departmentalstatistics for budgetary and reporting purposes.Explain bi llsaccording to PRMO credit and collection policies. Implement appropria tecollection actions and assist financially responsible persons inarrang ing payment. Make referral for financial counseling. Determinenecessity of third party sponsorship and process patients in accordancewith policy and procedure. Examine insurance policies and other thirdparty sponsors hip materials for sources of payment. Inform attendingphysician of patie nt financialhardship. Complete the managed carewaiver form for patients considered out of network and receivingservices at a reduced benefit le vel. Update the billing system toreflect the insurance status of the pat ient. Refer patients to theManufacturer Drug program as needed for medic ations. Greet andprovides assistance to visitors and patients. Explain p olicies andprocedures, and resolves problems. Gathers necessary document ation tosupport proper handling of inquiries and complaints. Assist with departmental coverage as requested.Obtain authorizations basedon insuran ce plan contracts and guidelines. Document billing systemaccording to po licy and procedure. Enter and update referrals asrequired. Communicate w ith insurance carriers regarding clinicalinformation requested and to re solve issues relating to coverage andpayment.
Knowledge, Ski lls and Abilities
Excellent communication skills, oral and writt en. Ability to analyzedata, perform multiple tasks and work independentl y. Must be able todevelop and maintain professional, service-oriented wo rkingrelationships with patients, physicians, co-workers and supervisors .Must be able to understand and comply with policies and procedures.
Position responsible for high prod uction generated accurately inaccordance with established business proce sses or regulation. Requiresworking knowledge of compliance principles. Job allows the opportunityto work independently.
Work requires knowledge of basic grammar and mathematical principles normally required through a high school education, with some postsecondary education preferred. Additional training or working knowledge of related business.
Two years experience working in hospital service access, clinical service access, physician office or billing and collections. Or, an Associate's degree in a healthcare related field and oneyear of experience working with the public. Or, a Bachelor's degree and one year of experience working with the public.
Degrees, Licensures, Certifications
Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
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Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.
As a world-class academic and health care system, Duke Health strives to transform medicine and health locally and globally through innovative scientific research, rapid translation of breakthrough discoveries, educating future clinical and scientific leaders, advocating and practicing evidence-based medicine to improve community health, and leading efforts to eliminate health inequalities.