PRMO Established in 2001, Patient Revenue Management Organization (PRMO) is a fully integrated, centralized revenue cycle organization supporting all of Duke Health, including Duke University Hospital, Duke Regional Hospital, Duke Raleigh Hospital, the Private Diagnostic Clinic, and Duke Primary Care. The PRMO focuses on streamlining the revenue cycle through enhanced management of scheduling, registration, coding, HIM operations, billing, collections, cash management, and customer service. The Mission of the PRMO is delivering quality service by enhancing the patient experience, providing financial security, and preserving Dukeâ€™s reputation and mission of advancing health together. Our Vision is to be recognized as a world class innovative revenue cycle organization that values our people, patients and performance.
***$5000.00 Commitment Bonus (2 installments over 12 months in 6-month increments)
* Only new hires who have not worked for Duke University in the past 12 months (at the time of offer) are eligible to receive the sign-on bonus.
Duke University Health System - Patient Revenue Management Office (PRM O) seeks to hire a Financial Care Counselor who will embrace our mission of Advancing Health Together.
Accurately complete patient accounts based on departmental protocols, policies, and procedures and compliance with regulatory agencies, including but not limited to pre-admission, admission, pre-registration, and registration functions.
Ensure all insurance requirements are met before patients' arrival, and inform patients of their financial liability before they arrive for services. Arrange payment options with the patients and screen patients for government funding sources.
7:30 a.m. to 6:00 p.m. Mon - Thurs
Analyze insurance coverage and benefits for service to ensure timely
Obtain authorizations based on payment based on the insurance plan's contracts and guidelines.
Document billing system.
Explain Bills provides assistance to visitors and patients.
Explain policies and departmental coverage as requested.
Calculate and follow PRMO credit and collection policies.
Implement appropriate cash payments for all patients.
Reconcile the daily necessity of third-party sponsorship and process patients in accordance with reimbursement.
Obtain all prior authorization certifications and/or authorizations as appropriate.
Facilitate payment sources for uninsured patients.
Determine if the patient's condition is the result of an accident and perform complete research to determine the appropriate source of liability or payment.
Admit, register, and pre-register patients with accurate patient demographic and financial data.
Resolve insurance claim rejections and denials and remedy expediently.
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.
Collection actions and assist financially responsible persons in arranging payment.
Make a referral for financial counseling.
Determine the policy and procedure.
Examine insurance policies and other third-party sponsorship materials for sources of payment.
Inform the attending physician of the patient's 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's drug program as needed for medications.
Greets and procedures and resolves problems.
Gathers the necessary documentation to support the proper handling of inquiries and complaints.
Assist according to policy and procedure.
Enter and update referrals as required.
Communicate with insurance carriers regarding clinical information requested an d to resolve issues relating to coverage
Knowledge, Skills and Abilities
Excellent communication skills, oral and written.
Ability to analyze relationships with patients, physicians, co-workers, supervise data, perform multiple tasks, and work independently
Must be able to develop and maintain professional, service-oriented work,
Must be able to understand and comply with policies and procedures.
Positions responsible for high production are generated accurately in accordance with established business processes or regulations.
It requires working knowledge of compliance principles. The job provides the opportunity to work independently.
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 businesses
Two years of experience working in hospital service access,clinical service access, the 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
Job Code: 00004500 FINANCIAL CARE COUNSELOR Job L evel: C1
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Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob 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.
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