Financial Care Counselor - Duke Eye Center Mebane

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Duke Health Integrated Practice

Duke Health Integrated Practice comprises more than 110 primary and specialty outpatient clinics, extending the reach of the Duke Health mission across the state of North Carolina.

$5000 Commitment Bonus for qualifying candidates!

JOB LOCATION

Duke Eye Center of Mebane - 480 Gregory Poole Lane, Mebane, NC

JOB SUMMARY

We are seeking a Financial Care Counselor to accurately completes patient financial and registration activities according to departmental policies, procedures, and regulatory requirements. This position verifies insurance requirements, informs patients of their financial responsibility, assists with payment arrangements and financial assistance options, and supports accurate and timely reimbursement for services.

JOB DUTIES AND RESPONSIBILITIES

• Analyze patient insurance coverage and benefits for scheduled services to support accurate billing and timely reimbursement.

• Obtain prior authorizations, certifications, and other required approvals according to insurance plan contracts and guidelines.

• Admit, register, and pre-register patients using accurate demographic, insurance, and financial information.

• Review and update the billing system to accurately reflect the patient's current insurance and financial status.

• Determine whether a patient's condition resulted from an accident and complete appropriate research to identify the responsible source of liability or payment.

• Examine insurance policies and other third-party sponsorship information to identify available sources of payment.

• Determine whether third-party sponsorship is necessary and process patients according to established policies and procedures.

• Facilitate payment resources and financial assistance options for uninsured or underinsured patients.

• Calculate, collect, post, and reconcile patient payments accurately.

• Reconcile daily cash deposits according to established cash-management procedures.

• Explain patient bills, balances, payment expectations, and collection policies according to PRMO credit and collection guidelines.

• Implement appropriate collection activities and assist financially responsible individuals with arranging payment options.

• Refer patients for additional financial counseling when appropriate.

• Inform the attending physician or appropriate clinical team member when a patient reports financial hardship that may affect the planned service.

• Refer eligible patients to manufacturer drug assistance programs when medication assistance may be needed.

• Complete managed care waiver forms for patients who are out of network or receiving services at a reduced benefit level.

• Communicate with insurance carriers regarding requested clinical information, insurance coverage, prior authorization, and payment-related issues.

• Resolve insurance claim rejections and denials accurately and as promptly as possible.

• Evaluate diagnoses as appropriate to support compliance with applicable Medicare coverage policies.

• Enter, update, and maintain referral and authorization information in the billing system according to policy and procedure.

• Perform all duties necessary to ensure patient accounts are processed accurately and efficiently.

• Compile departmental statistics and reports for operational, budgetary, and reporting purposes.

• Greet patients and visitors and provide professional, courteous, and service-oriented assistance.

• Explain departmental policies and procedures and assist with resolving patient questions, concerns, inquiries, and complaints.

• Gather required documentation to support the appropriate review and resolution of patient inquiries or complaints.

• Provide departmental coverage and perform additional job-related duties as requested.

JOB ELIGIBILITY REQUIREMENTS

• 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 Associates degree in a healthcare related field and one year of experience working with the public. Or, a Bachelors degree and one year of experience working with the public.
• The position requires excellent oral and written communication skills.
• The employee must be able to analyze information and data, manage multiple responsibilities, maintain accuracy, and work independently.
• The employee must be able to develop and maintain professional, service-oriented working relationships with patients, physicians, coworkers, supervisors, insurance representatives, and other internal and external partners.
• The employee must be able to understand, apply, and comply with departmental policies, procedures, regulatory requirements, insurance guidelines, and established business processes.
• The position requires working knowledge of compliance principles and the ability to complete a high volume of work accurately and efficiently.

JOB HOURS

The schedule for this position is day shifts, Monday-Friday, with no weekends or holidays.

Duke is an Equal Opportunity Employer committed to providing employment opportunity without regard to an individuals age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex (including pregnancy and pregnancy related conditions), sexual orientation or military 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.