What are the responsibilities and job description for the Financial Care Counselor position at Duke?
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About Duke Health's Patient Revenue Management Organization
Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.
Duties and Responsibilities of this Level: • Identifies, admits, schedules, registers and pre-registers patientswith accurate patient demographic and financial data. Meets or exceeds data quality goals.• Explain all required registration andbilling forms and obtain signatures whereapplicable• Verifies insurance benefits using our electronic insurance verification system and/or contacts payers via website or phone. Assigns the correct coverage to the patient’s account.• Completes the Medicare Secondary Payer Questionnaire (MSPQ); • collects point-of-service payments. Meets or exceeds collection goals.
• Creates estimates for upcoming services wh enapplicable.• Arranges payment plans and offers financial assistance when applicable.• Reconciles daily cash deposits. • Performs duties necessary to ensure all accounts are processedaccurately and efficiently.• Greetsa nd provides assistance to our patients and visitors.• Exhibits the DUHSV alues (E(Excellence, Safety, Integrity, Diversity and Teamwork) at alltimes wwhile on duty.• Explains policies and procedures and resolve proble ms. Gathernecessary documentation to ssupport proper handling of inquiri es and complaints.
• Explain bills according to PRMO financial assistance policies.• Resolves claim edits; • Researches denials and remedy expedien tly.• Completes a non-covered waiver form for patients considered out of network and receiving services at a reduced benefit level.• Completes waiver for non-authorized services• Obtain authorizations based on insurance plan contracts andguidelines.• Document the billing system according t o policy and procedure.• Enter and update referrals as required.• Assists with departmental coverage as requested.
Experience: Two years’ experience working in hospital service access, clinical service access, physician office, or billing and collections, or an Associate's in a healthcare-related field and one year of experience with the public, or a Bachelor's degree and one year of experience working with the public are required.Degrees, Licensure, and/or communication skills, oral and in writing.
Ability to analyze data and work independently. Must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, c o-workers and supervisors. Must be able to understand and comply with policies and procedures.Distinguishing Characteristics of this Level:This position is deemed “essential”. Essential staff are expected to report to work during inclement weather. This position is responsible for high productivity, generated accurately in accordance with established business processes or regulatory requirements. Bedside registration is performed in the emergency department and on the inpatient units. This position requires long periods of walking, standing and sitting.
This position requires working knowledge of compliance principles. The job allows the opportunity to work independently.The intent of this description is to provide a representative level of the types of duties and responsibilities that will be required of positions given this title and shall not be construed as a declaration of the total of the specific duties and responsibilities of any particular position. Employees may be directed to perform job-related tasks other than those specifically presented in this description.
Experience: Required qualifications at this level are preferred.The intent of this job description is to provide a represen tative and Education: responsibilities that will be required of positions given this title: declaration of the total of the specific duties, responsibilities and level of the types of duties and not be construed as aKnowledge, Skills, and Abilities:Identify, admit, schedule, register and pre-register patients with accurate patient demographic and financial data. Resolve insurance claim rejections/denials.
Verify insurance benefits. Provide insurance benefit interpretation and counseling. Calculate andcollect payments appropriately forall patients. Assist financiallyresponsible persons in arrangingpayment.Reconcile the daily cash deposit. Meet collection and data qualitygoals. Perform the duties necessary to ensure all accounts are processed accurately. Explain all required registration and billing forms and obtain signatures where applicable.Explain bills according toPRMO financialassi PRMO financial assiPRMO financial assistance policies. Make a referral for financial assistance when applicable. Complete a 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.Greet and provide assistance to ourpatients and visitors. Exhibit the DUHS values (excellence, safety, integrity, Diversity and teamwork) at all times while on duty.Explain policies and procedures, and resolve problems. Gather the necessary documentation to support the proper handling of inquiries and complaints.Work requires knowledge of basic grammar and mathematical principles normally required through high school education, with some postsecondary education preferred.Additional training or working knowledge in related businesses will be considered.Ability to analyze data, perform multiple le 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 tounderstand and comply with p olicies and procedures. Bilingual isDistinguishing Characteristics of this Level:The part-time FCC will support the Duke University Hospital, Duke Regional Hospital, and Duke Raleigh Hospital emergency departments. Part-time FCCs can be scheduled to work all shifts and locations based on availability and departmental needs.
This position is not eligible for Duke University Health System benefits, including medical/dental/vision, paid time off , or the DUHS retirement plan. A minimum number of work hours is not guaranteed per week. This position is #essential#. Essential staff are expected to report to work during inclement weather. This position is responsible for high productivity, generated accurately in accordance with established business processes or regulatory requirements. Bedside registration is performed in the emergency departments. This position requires long periods of walking, standing and sitting. This position requires working knowledge of compliance principles. Job allows the opportunity to work independently in any particular position.Employees may be directed to perform job-related tasks other than those specifically presented in this description.
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, licenses, and certifications
None required
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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.
