Financial Care Counselor

Location
North Carolina, United States
Posted
04 Dec 2018
End of advertisement period
04 Feb 2019
Ref
401519445
Contract Type
Permanent
Hours
Full Time

Job Description

POSITION SUMMARY

Case Manager/liaison between the patient’s payer source and all DHCH programs. The Financial Care Counselor’s role is to obtain the initial authorization for services being rendered by the DHCH programs. If  reauthorization  is required, in order for services to be continued, the Financial Care Counselor is involved in getting the additional authorization as well. This position plays a critical role in helping to secure that DHCH programs will receive payment for the services they are performing when claims are filed to the payer source. This position must be able to work independently. 

POSITION RELATIONS

Responsible to: Manager, Business Development

POSITION RESPONSIBILITIES:

Insures confidentiality of patient information through HIPAA Compliance. Obtains authorizations based on insurance plan contracts and guidelines. Documents billing systems according to policy and procedure.

  • Communicates with payer sources and DHCH programs regarding clinical information requested, in order to obtain all authorizations.
  • Resolves issues related to obtaining authorizations from payer sources, so services can be rendered.
  • Notifies manager of any authorization concerns.
  • Communicates to manager any IT issues.
  • Runs the authorization expiration report in billing systems, and notifies the programs they need to determine if additional authorization is going to be needed.
  • Performs special projects as assigned and other duties as requested.   

QUALIFICATIONS 

The individual must be very detail-oriented and possess time management, analytical, and organizational skills. The individual must be able to work in a fast paced environment and meet deadlines and established goals. This individual must be able to work independently and  have great focus. The individual must be accurate and efficient in performing their job duties. 

EDUCATION AND TRAINING:

Refer to the Duke University/DUHS official classification description for minimum requirements. DHCH preferred requirements are: 
High school diploma or equivalent. Strong understanding of reimbursement guidelines, case management, medical terminology, coding, third party benefits and collection techniques. Must be computer literate.

WORK EXPERIENCE :

Refer to the Duke University/DUHS official classification description for minimum requirements. DHCH preferred requirements are: 
Work requires two years of experience in obtaining prior authorization certification and/or case management in a health care setting, and/or experience in billing and reimbursement.  

KNOWLEDGE, SKILLS, AND ABILITIES

Excellent 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, pay sources, co-workers, and leadership. Must be able to understand and comply with policies and  procedures.  

Requisition Number 401519445
Location Durham
Duke Entity DUKE HOMECARE AND HOSPICE
Job Code 4500 FINANCIAL CARE COUNSELOR
Job Family Level C1
Exempt/Non-Exempt Non-exempt
Full Time / Part Time FULL TIME
Regular / Temporary Regular
Shift First/Day

Minimum Qualifications

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.

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

Auto req ID 106953BR