Financial Care Counselor - Signature Care of South Durham

Financial Care Counselor - Signature Care of South Durham

Job Location: Signature Care of South Durham - 234 Crooked Creek Pkwy

Job Summary

We are seeking a Financial Care Counselor for Duke Signature Care South Durham, a Primary Care Medical Home and concierge care practice located at 234 Crooked Creek Parkway. The Financial Care Counselor provides comprehensive financial counseling to patients regarding their healthcare services, verifies insurance eligibility and benefits, and obtains pre-certification and authorization for services and procedures. Financial Care Counselors enhance the patient experience by providing insight into insurance plan requirements, maximizing third party payment for services, and reducing the patient out of pocket expense.

Job Duties and Responsibilities

• Populate estimated patient liability information in electronic health record into patient's account.
• Conduct research to ensure patient information is complete, identify services being rendered, and resolve billing inquiries.
• Verify and complete insurance benefit collection using current eligibility vendors or other available tools; verify by phone when online resources are exhausted.
• Update patient registration information when demographics, new insurance or insurance changes are identified.
• Receive inbound calls from patients and provide an estimate for potential services.
• Collect estimated patient liability and provide financial counseling to include explanation of coverage/insurance benefits, how benefits relate to estimated patient liability and information on all account balances.
• Document all patient conversations in electronic health record to alert staff if/when follow-up at arrival is required.
• Cash management- reconcile daily cash deposits, ensure daily collection batches are closed and accurate with system records; ensure all deposits are made according to cash management policy; and perform monthly cash audits with clinic management and report any discrepancies/issues.
• Calculate and collect cash payments appropriately for all patients.
• Investigate and resolve insurance claim rejection/denials and remedy; communicate with patients regarding billing and any outstanding balances for services rendered. Determine necessary processes for setting up payment or making corrections to resend claims to ensure payment.
• Consistently update patient insurance coverage and complete managed care waivers for patients considered out of network.
• Review denials and claim edits in the FCC work queues daily; make corrections as needed to ensure payment and reduce patient out of pocket expense for services provided.
• Communicate with insurance carriers regarding clinical information requested to solve related to coverage and payment.
• Complete check in/check out, collect fees, and make additional appointments for Travel Vaccine Clinic patients (typically 2 days per week).
• Perform other clinic duties as assigned, including but not limited to check in/check out process, monitor and address EPIC in-basket messages, orders, work queues, and referrals; collect membership fees; provide float coverage to alternate clinic site as needed.

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 of experience working in a 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 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.

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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.