- Analyze insurance coverage and benefits for service to ensure timely 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. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage and payment Document billing system according to policy and procedure.
- Explain bills according to PRMO credit and collection policies. Adheres to PRMO Cash Management Policies and Procedures. Implement appropriate collection actions and assist financially responsible persons in arranging payment. Make referral for financial counseling. Determine 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 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. Explain policies and procedures, and resolves problems. Gathers necessary documentation to support proper handling of inquiries and complaints.
- Greets and provides assistance to visitors. Check-in patient upon arrival in the practice. Identify correct patient information in Maestro Care. Accurately identify the appropriate account for patient visit. Present and educate patients on required forms and obtain signature as required by policy and procedure. Completes all Maestro Care check-in files and manage all appropriate alerts. Imprint all patient specific chart documents and requisition/transmittal documents. Copy, file and distribute insurance cards as indicated by procedure. Coordinate all labs/procedures as requested. Maintain private physician office charts.
- Check-out patients. Make return appointments by scheduling patients into the correct appointment type, entering the primary care physician or referring physician and scheduling tests and procedures.
- Answer telephone, take and deliver messages to physicians, nurses and others. Report obtained medical information from patients and referring physicians accurately, completely and timely. Disseminate messages according to practice communication standards.
- Labeling and scanning external documents into EMR.
- 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 one year of experience working with the public. Or, a Bachelor's degree and one year of experience working with the public.
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FINANCIAL CARE COUNSELOR - Winston-Salem, United States - Duke University
Description
Duke Health Integrated Practice is an exceptional, multi-specialty physician practice encompassing 140 clinics across North Carolina. We attract and retain premier medical professionals with competitive compensation, benefits, and a nurturing work atmosphere that unites passion and purpose.
Learn more about us:
JOB LOCATION
Duke Eye Center of Winston Salem Creekshire Way
JOB SUMMARY
We are seeking a Financial Care Counselor to 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.
JOB DUTIES AND RESPONSIBILITIES
The schedule for this position is day shifts, Monday-Friday, with no weekends or holidays.
Some roles within our organization may encompass essential job functions requiring distinct physical and/or mental capabilities. Further details and accommodation requests will be addressed by individual hiring departments.
Duke Health Integrated Practice is dedicated to Equal Opportunity Employment, fostering a diverse workforce without regard to age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.
We aspire to build a community grounded in collaboration, innovation, creativity, and belonging. Our shared achievements rely on a dynamic exchange of ideas, flourishing best when a multitude of perspectives, backgrounds, and experiences thrive. Upholding these values is a collective responsibility within our community.
This job description aims to outline representative responsibilities for this title, not an exhaustive account of specific duties. Employees may be assigned job-related tasks beyond those explicitly outlined here.
