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    Financial Care Counselor - Raleigh, NC, United States - Duke Health

    Duke Health background
    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)

    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.

    Analyze insurance coverage and benefits for service to ensure timely.
    Document billing system.
    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.
    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.
    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.
    Gathers necessary documentation to support proper handling of inquiries and complaints.
    Assist with according to policy and procedure.
    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.

    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.

    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.


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