Financial Care Counselor - Duke Eye Center of Winston Salem

Job description

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together. 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 Winston Salem - 1340 Creekshire Way JOB SUMMARY We are seeking a Financial Care Counselor to 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. JOB 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. Enter and update referrals as required. Communicate with insurance carriers regarding clinical information requested and to resolve issues relating to coverage and payment Document billing system according to policy and procedure. Explain bills according to PRMO credit and collection policies. Adheres to PRMO Cash Management Policies and Procedures. 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. Explain policies and procedures, and resolves problems. Gathers necessary documentation to support proper handling of inquiries and complaints. Greets and provides assistance to visitors. Check-in patient upon arrival in the practice. Identify correct patient information in Maestro Care. Accurately identify the appropriate account for patient visit. Present and educate patients on required forms and obtain signature as required by policy and procedure. Completes all Maestro Care check-in files and manage all appropriate alerts. Imprint all patient specific chart documents and requisition/transmittal documents. Copy, file and distribute insurance cards as indicated by procedure. Coordinate all labs/procedures as requested. Maintain private physician office charts. Check-out patients. Make return appointments by scheduling patients into the correct appointment type, entering the primary care physician or referring physician and scheduling tests and procedures. Answer telephone, take and deliver messages to physicians, nurses and others. Report obtained medical information from patients and referring physicians accurately, completely and timely. Disseminate messages according to practice communication standards. Labeling and scanning external documents into EMR. 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 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. 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, physicians, co-workers and supervisors. Must be able to understand and comply with policies and procedures. Knowledge of EPIC a plus. 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 individual's 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.