Financial Care Counselor - DRAH ED
Company: Nurse.com
Location: Durham
Posted on: January 26, 2023
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 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.***$2500.00 Sign On Bonus (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 sign-on
bonus.Work HoursMonday - Thursday 5:30pm - 4:00amWork 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
coverageKnowledge, 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
QUALIFICATIONSEducationWork 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.ExperienceTwo
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,
CertificationsNone requiredDuke 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: Nurse.com, Durham , Financial Care Counselor - DRAH ED, Accounting, Auditing , Durham, North Carolina
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