ACCESS SPECIALIST II
- Location: Durham, NC
- Posted: Sep 5, 2019
DUKE CONSULTATION & REFERRAL CENTER
Explain billing to patients for information. Excellent communication skills, oral and written. Ability to analyze relationships with patients, physicians, co-workers and supervisors.comply with policies and procedures.Work independently. Must be able to develop and maintain professional,data, perform multiple tasks and service-oriented working. Analyze insurance coverage and benefits for service to ensure timely. Obtain authorizations based uninsured patients. Determine if patient's condition is the result of patient research to determine the appropriate source of liability/payment.departmental coverage as requested. Responsible for accurate and complete patient accounts based on departmental protocol, policies procedures, and compliance with regulatory agencies, to include but not limited to pre-admission,admission, pre-registration and registration functions. Ensure all insurance requirements are met prior to patients' arrival, and inform patients of their financial liability. Arranges payment options with the patients and screens patients for government funding sources. This is position has high customer service with our payors and physicians by phone and requires excellent customer service skills.This position is very similar to the Financial Care Counselor. This position completes all preliminary work.The Financial Counselor completes the work when the patient arrives reimbursement. Obtain al lPAC and/or authorizations as appropriate. Facilitate referral to Financial services for payment sources an accident, performing complete. Schedules and pre-register patients,correcting as necessary all patient demographic and financial data.Resolve insurance claim rejections/denials and remedy expediently. Call patients to remind them to bring balances due, co- pays,co insurance and deductible. Evaluate diagnoses to ensure compliance with the Local Medicare Review Policy. Perform those duties necessary to ensure all accounts are processed accurately efficiently. Promote and maintain excellence in customer service.according to PRMO credit and collection policies, when discussing insurance with patients.Implement appropriate collection actions and assist financially responsible persons in arranging payment.Make referral to Financial Services Representative for counseling. Determine necessity of third party sponsorship and process patients per policy and procedure. Examine insurance policies and other third party sponsorship materials for sources of payment. Inform attending physician of patient financial hardship. Update the billing system to reflect the insurance status of Provides timely and effective customer service to internal customers. Assist with on insurance plan contracts / guidelines, document in billing system per policy and procedure.Enter and update referral s as required. Communicate with insurance carriers regarding clinical requested and to resolve issues relating to coverage and payment for specific patients and benefits.Must be able to understand
A high school diploma or equivalent is required. College or completion of post-secondary education is preferred.
Minimum of 2 years of health care related or call center experience. An associate degree or higher may substitute for the experience requirement.
Degrees, Licensures, Certifications
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