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FINANCIAL CARE COUNSELOR - DRAH OUTPATIENT SERVICE ACCESS 1

Employer
Duke University
Location
DRAH OUTPATIENT SERVICE ACCESS 1
Closing date
Jul 23, 2021

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Administrative Jobs
Institutional & Business Affairs, Business & Financial Management
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Job Details

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.

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.

Work 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 coverage

Knowledge, 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 QUALIFICATIONS

Education

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.

Experience

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

None required

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.

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.

Company

Read our Diversity Profile History

Duke University was created in 1924 by James Buchanan Duke as a memorial to his father, Washington Duke. The Dukes, a Durham family that built a worldwide financial empire in the manufacture of tobacco products and developed electricity production in the Carolinas, long had been interested in Trinity College. Trinity traced its roots to 1838 in nearby Randolph County when local Methodist and Quaker communities opened Union Institute. The school, then named Trinity College, moved to Durham in 1892, where Benjamin Newton Duke served as a primary benefactor and link with the Duke family until his death in 1929. In December 1924, the provisions of indenture by Benjamin’s brother, James B. Duke, created the family philanthropic foundation, The Duke Endowment, which provided for the expansion of Trinity College into Duke University.Duke Campus

As a result of the Duke gift, Trinity underwent both physical and academic expansion. The original Durham campus became known as East Campus when it was rebuilt in stately Georgian architecture. West Campus, Gothic in style and dominated by the soaring 210-foot tower of Duke Chapel, opened in 1930. East Campus served as home of the Woman's College of Duke University until 1972, when the men's and women's undergraduate colleges merged. Both men and women undergraduates now enroll in either the Trinity College of Arts & Sciences or the Pratt School of Engineering. In 1995, East Campus became the home for all first-year students.

Duke maintains a historic affiliation with the United Methodist Church.

Home of the Blue Devils, Duke University has about 13,000 undergraduate and graduate students and a world-class faculty helping to expand the frontiers of knowledge. The university has a strong commitment to applying knowledge in service to society, both near its North Carolina campus and around the world.

Mission Statement

Duke Science"James B. Duke's founding Indenture of Duke University directed the members of the University to 'provide real leadership in the educational world' by choosing individuals of 'outstanding character, ability, and vision' to serve as its officers, trustees and faculty; by carefully selecting students of 'character, determination and application;' and by pursuing those areas of teaching and scholarship that would 'most help to develop our resources, increase our wisdom, and promote human happiness.'

“To these ends, the mission of Duke University is to provide a superior liberal education to undergraduate students, attending not only to their intellectual growth but also to their development as adults committed to high ethical standards and full participation as leaders in their communities; to prepare future members of the learned professions for lives of skilled and ethical service by providing excellent graduate and professional education; to advance the frontiers of knowledge and contribute boldly to the international community of scholarship; to promote an intellectual environment built on a commitment to free and open inquiry; to help those who suffer, cure disease, and promote health, through sophisticated medical research and thoughtful patient care; to provide wide ranging educational opportunities, on and beyond our campuses, for traditional students, active professionals and life-long learners using the power of information technologies; and to promote a deep appreciation for the range of human difference and potential, a sense of the obligations and rewards of citizenship, and a commitment to learning, freedom and truth.Duke Meeting

 “By pursuing these objectives with vision and integrity, Duke University seeks to engage the mind, elevate the spirit, and stimulate the best effort of all who are associated with the University; to contribute in diverse ways to the local community, the state, the nation and the world; and to attain and maintain a place of real leadership in all that we do.”

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