Financial Care Counselor - Spine

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.

$5,000 Commitment Bonus for qualifying candidates!

JOB LOCATION:

Piedmont Spine Specialists - 3480 Wake Forest Rd

JOB SUMMARY:

We are seeking a Financial Care Counselor in our Piedmont Spine Specialists located in Raleigh, NC to be an integral member of the healthcare team to provide direct and indirect care to patients.

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.
• 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.

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.

JOB HOURS:

The position is Monday through Friday day shift, hours will vary. No weekends and no nights.

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.