Financial Care Counselor - Duke Integrative Medicine

Duke Integrative Medicine, located on the Center for Living Campus, is seeking a Financial Care Counselor to join our Guest Services team. This role requires a high level of accuracy, critical thinking, excellent communication, and exceptional customer service skills.

As part of Duke Integrative Medicine, you will be part of a team that supports your well-being and provides an excellent work environment.

This is an on-site position
Monday - Friday
8:00 am - 5:00 pm

General Job Description

• Accurately complete patient accounts per departmental protocols, policies, procedures, and regulatory compliance.
• Perform pre-admission, admission, pre-registration, and registration functions.
• Ensure insurance requirements are met before patient arrival.
• Inform patients of financial liability prior to service.
• Arrange payment options with patients and screen for government funding eligibility.

Key Duties and Responsibilities

• Analyze insurance coverage and benefits to ensure timely reimbursement.
• Obtain prior authorizations and certifications as needed.
• Facilitate payment options for uninsured patients.
• Investigate accidents to determine liability and appropriate payer sources.
• Accurately admit, register, and pre-register patients with demographic and financial data.
• Resolve insurance claim rejections and denials promptly.
• Calculate and collect patient payments; reconcile daily cash deposits.
• Evaluate diagnoses for Medicare policy compliance.
• Ensure all accounts are processed accurately and efficiently.
• Compile departmental statistics for budgets and reporting.
• Explain bills per PRMO credit and collection policies.
• Initiate and manage appropriate collection efforts and assist with payment plans.
• Refer patients for financial counseling as needed.
• Assess need for and process third-party sponsorships.
• Review insurance policies and funding materials to determine payment sources.
• Notify physicians of patients experiencing financial hardship.
• Complete managed care waiver forms for out-of-network patients.
• Update billing systems with accurate insurance status.
• Refer patients to Manufacturer Drug Programs as needed.
• Greet and assist patients and visitors; explain policies and resolve issues.
• Gather documentation to support inquiries and complaints.
• Provide departmental coverage upon request.
• Obtain authorizations based on insurance guidelines and contracts.
• Accurately document in billing systems per policy and procedure.
• Enter and update referrals as needed.
• Communicate with insurance carriers to resolve clinical and coverage issues.

Required Qualifications

Education

• High school diploma required; some post-secondary education preferred.
• Additional training or working knowledge of related business functions is desirable.

Experience

• Option 1: Two years of experience in hospital or clinical service access, physician office, or billing/collections.
• Option 2: Associate's degree in a healthcare-related field and one year of public-facing experience.
• Option 3: Bachelor's degree and one year of public-facing experience.

Degrees, Licensure, Certification

• None required.

Knowledge, Skills, and Abilities

• Excellent oral and written communication skills.
• Ability to analyze data, multitask, and work independently.
• Strong interpersonal skills; able to build service-oriented relationships.
• Understanding of and adherence to institutional policies and procedures.

Distinguishing Characteristics

• High-volume, accurate production in alignment with established business processes and compliance standards.
• Requires working knowledge of healthcare compliance principles.
• Role allows for independent work and decision-making.

Other Notes

• This description reflects representative duties, not an exhaustive list.

Employees may be asked to perform job-related tasks not specified here.

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 onthe 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.