Full-Time
Financial Care Counselor
Duke University
No salary listed
Durham, NC, USA
In Person
Category
 Accounting (1) |
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Requirements
- 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 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.
Responsibilities
- 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 reimbursement.
- Obtain all prior authorization certifications 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 pre-register patients with accurate patient demographic andfinancial data.
- Resolve insurance claim rejections/denials and remedy expediently.
- Calculate and collect cash payments appropriately for all patients.
- Reconcile 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 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.
- Greets and provides assistance to visitors and patients.
- Explains policies and procedures and resolves 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 the 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.