FINANCIAL CARE COUNSELOR - PRE-VISIT COLLECTIONS
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 PrimaryCare. 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.
HOURS OF OPERATION: 9:30 AM-6:00 PM
FINANCIAL CARE COUNSELOR-PRE-VISIT COLLECTIONS
Pre-Visit Collections Job Description Summary: The primary focus of this position is preparing estimates of patient liability for high dollar outpatient and inpatient services.Patients are contacted by telephone,educated on their patient liability and offered payment options.Performance is measured by productivity and collections.Roles and ResponsibilitiesVerifies Insurance and Benefits for Estimate Preparation.Verifies insurance eligibility and benefits using current eligibility vendors or other available online tools, or by telephone when online resources are exhausted.If benefits not already entered, enters all core benefits specific to the scheduled service (e.g. outof pocket max, lifetime max, deductible amount) on Benefit Collection screen in Epic.Updates Registration when new insurance or insurance changes are identified B.Creating Estimates.Reviews Authorization/Certification Information in Epic for CPT procedure codes needed to calculate estimate and enters codes correctly in estimation tool. Informs Patients of Estimated Liability.Explains coverage/benefits comprehensively to patients and how benefits relate to estimated charges.Answers questions related to patient specific benefits and estimate breakdown.Communicates patient liability prior to time of service and attempts to collect payment or establish acceptable payment arrangements.Follows approved telephone script in delivering message to patients.Informs patient of all account balances.Communicates and Works Effectively with Other Staff to Achieve Goals.Documents all patient conversations in Epic under Pre-Visit Estimate Info/Pre- payment notes.Updates Estimate Call Result field in Epic with appropriate response to alert POS staff if or when follow up at arrival is required.Answers incoming calls and assists with requests for pricing/ estimate information from patients,prospective patients, and internal customers.Serves as a subject matter expert for use of Epic.Estimates tool.Identifies potential financial risks beyond immediate service area and communicates / works with other Financial Counselors to manage patient financial issues.Documents actions appropriately in core systems, shares patient interactions and resolutions with others.Communicates and behaves professionally at all times, demonstrates flexibility, using appropriate communication techniques, verbally validates other perspectives.Follows policy and procedure in order to (at minimum). Achieve Expectations in relation to OER.Demonstrates an enthusiasm for patient education and collection of patient responsibility.
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.
Degrees, Licensures, Certifications
Knowledge, Skills and AbilitiesExcellent 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.Ability and willingness to take initiative and problem-solve/trouble-shoot in ambiguous and new situations.Thrives in a team environment; demonstrates strong personal accountability and follow-through.High customer focus. 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. Highly Preferred: Epic/Maestro Care proficiency, Patient Access experience, Customer Service experience, and Insurance Benefit.
Duke University 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 essential job 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.
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