Financial Care Counselor,Center for Transitional Pain Medicine
Center for Transitional Pain Medicine
Center for Transitional Pain Medicine - Brier Creek
- 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.
Duties and Responsibilities:
- 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.
- Calculate and collect cash payments appropriately for all patients.
- Reconcile daily cash deposit.
- 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.
- Explain bills according to PRMO credit and collection policies.
- 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.
- Greet and provides assistance to visitors and patients.
- Explain policies and procedures, and resolves problems.
- Gathers necessary documentation to support proper handling of inquiries and complaints.
- Assist with departmental coverage as requested.
- Obtain authorizations based on insurance plan contracts and guidelines.
- Document billing system 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 and payment.
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.
- 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.
- Must be able to work under time pressures in a busy clinic/office environment.
- Must be present on site for 8 hour shifts during standard business hours.
- Must participate in group activities requiring interpersonal skills & cooperation.
- Must work as late person when scheduled or according to business needs
- Must be able to react quickly and immediately respond to emergencies.
- Must travel between locations on needed basis.
- Must be able to handle multiple assignments, conflicting demands & priorities.
- Must maintain attention to detail over extended period of time.
- Must be continually aware of variations in changing situations.
- Must be able to move throughout office environment throughout day.
- Must be able to lift 25 lbs.
- Must be able to push/pull 200 lbs.
- Must be able to carry 25lbs
- Must be able to reach for objects by extending arms.
Requisition Number 401446863
Duke Entity PRIVATE DIAGNOSTIC CLINICS
Job Code 4500 FINANCIAL CARE COUNSELOR
Job Family Level C1
Full Time / Part Time FULL TIME
Regular / Temporary Regular
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.
Work requires knowledge of basic grammar and mathematical principlesnormally required through a high school education, with somepostsecondary education preferred. Additional training or workingknowledge of related business.
Two years experience working in hospital service access, clinicalservice access, physician office or billing and collections. Or, anAssociate's degree in a healthcare related field and one year ofexperience working with the public. Or, a Bachelor's degree and one yearof experience working with the public.
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