Financial Care Counselor - DRAH Outpatient Service Access (Float Position)
Company: Duke Health
Location: Raleigh
Posted on: April 25, 2024
Job Description:
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
Duke--------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. -Duke Raleigh Outpatient Service Access (Float
Position)Work hours: Hours ranging from 5:45 am to 7pm depending on
location. -*** DUHS Commitment Bonus Program $5000.00 (paid in 2
installments over 12 months - 6 month increments) **** Only new
hires who have not worked for Duke University in the past 12 months
(at the time of offer) are eligible to receive the commitment
bonus. -Duke University Health System - Patient Revenue Management
Office (PRMO) -seeks to hire a -Financial Care Counselor -who will
embrace our mission of Advancing Health Together. -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. -Work Performed -
- 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
-Knowledge, Skills and Abilities - -
- Excellent communication skills, oral and written.
- Ability to analyze relationships with patients, physicians,
co-workers and supervisors. data, perform multiple tasks and work
independently.
- Must be able to develop and maintain professional,
service-oriented working, -
- Must be able to understand and comply with policies and
procedures. -Level Characteristics -
- Position responsible for high production generated accurately
in accordance with established business processes or
regulation.
- Requires working knowledge of compliance principles. Job allows
the opportunity to work independently. - -MINIMUM QUALIFICATIONS
-Education - -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. -Experience -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 one year of
experience working with the public. Or, a Bachelor's degree and one
year of experience working with the public. -Degrees, Licensures,
Certifications -None required - - 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. - Duke aspires to create a
community built on collaboration, innovation, creativity, and
belonging. Our collective success depends on the robust exchange of
ideas-an exchange that is best when the rich diversity of our
perspectives, backgrounds, and experiences flourishes. To achieve
this exchange, it is essential that all members of the community
feel secure and welcome, that the contributions of all individuals
are respected, and that all voices are heard. All members of our
community have a responsibility to uphold these values. - 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. -
Keywords: Duke Health, Raleigh , Financial Care Counselor - DRAH Outpatient Service Access (Float Position), Accounting, Auditing , Raleigh, North Carolina
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