Berater im Sozialrecht für den Sozialverband VdK Bayern. Selbständige Mitgliederberatung zu sozialversicherungsrechtlichen Fragestellungen in Nürnberg.
About the role
- Financial Counselor managing patient accounts and liaising with patients regarding insurance and financial liabilities at Duke Health in Durham, NC.
Responsibilities
- Accurately complete patient accounts based on departmental protocol, policies and procedures, and compliance with regulatory agencies.
- 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 screen patients for government funding sources.
- 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 the patient's condition is the result of an accident and perform complete research to determine the appropriate source of liability/payment.
- Admit, register and preregister 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.
- 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 a referral for financial counseling.
- Determine the 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 the 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.
- Greets and provides assistance to visitors and patients. Explains policies and procedures and resolves problems.
- Gathers necessary documentation to support proper handling of inquiries and complaints.
Requirements
- Work requires knowledge of basic grammar and mathematical principles normally acquired through a high school education, with some postsecondary education preferred.
- Two years of 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.
Benefits
- One-time Commitment bonus: $5,000 (2 equal installments over 12 months—6-month increments)
Job title
Job type
Experience level
Salary
Not specified
Degree requirement
Location requirements
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