Financial Counselor-Marlborough

UMass Memorial Health•Marlborough, MA

1d•Onsite

About The Position

Under the general direction of the Financial Counseling Supervisor/Manager and/or Financial Clearance Director, the Financial Counselor (Certified Application Counselor) assesses health care coverage needs for patients, community applicants, and family members. The position determines eligibility for MassHealth, Qualified Health Plans, Children’s Health Insurance, the Health Safety Net, and other coverage programs, and provides guidance to patients, UMass staff, physician offices, and third-party vendors about financial assistance programs. The counselor interviews and screens applicants, supports enrollment through the Health Connector or other applications, follows up to obtain confidential information, and serves as a liaison with coverage agencies to help resolve eligibility and application issues. The role also supports the Financial Counseling call center, provides price estimates, works in EPIC work queues to identify uninsured or underinsured patients, coordinates with clinical and community partners to support access to care, discusses financial obligations before elective procedures or admissions, and updates patient account information. This is a day-shift position scheduled Monday through Friday, 8:00 a.m. to 4:30 p.m., for 40 hours per week. Work is considered light, with frequent walking, and takes place indoors in a normal office and/or patient care environment. The hiring range is $18.76–$29.96 per hour based on a full-time schedule; part-time or reduced schedules are prorated. A signing bonus may be available, subject to eligibility confirmation during the interview process.

Requirements

High school diploma or graduate credential.
Certified Application Counselor (CAC) certification required within 45 days of hire as a condition of employment.
Complete annual recertification and mandatory ongoing training through the Massachusetts online Learning Management System, and comply with privacy and security regulations and federal program standards.
Previous experience in healthcare, accounts receivable, financial counseling, medical billing, or a related field.
Proficient data-entry and strong organizational skills with attention to detail.
Effective verbal and written communication and customer service skills.
Ability to use specialized applications software and computer systems for patient registration and scheduling.
Ability to work independently and resolve problems effectively.
Must provide own transportation.
Ability to prioritize and work in a high-volume, fast-paced, team-oriented environment, take direction, and work independently.
English speaking, reading, and writing skills.
Comply with departmental policies and procedures, quality improvement practices, health and safety regulations, and required training.
Maintain regular, reliable, and predictable attendance.

Nice To Haves

Associate or bachelor’s degree in Business, Social Services, or a related field.
Bilingual speaking and reading ability.
An equivalent combination of education and experience may substitute for listed education or experience requirements when certification, licensure, or registration is not required.

Responsibilities

Interview, screen, and assess applicants and family members at on-campus locations using income, household composition, and other program eligibility criteria.
Determine eligibility for affordable health insurance coverage, including advance premium tax credits, premium assistance programs, Medicare Savings Plans, and other applicable programs.
Interact professionally with patients, community members, and outside agencies in keeping with UMass Memorial Health’s mission and vision.
Facilitate enrollment through the Health Connector Health Insurance Exchange or other program applications by submitting required paperwork accurately and on time in accordance with state and federal requirements.
Follow up with patients in person or by telephone to obtain confidential financial and medical information needed to complete applications and determine eligibility.
Liaise with MassHealth, the Health Connector, and the Health Safety Net to address eligibility discrepancies, application status questions, and related issues.
Explain health access options, eligibility rules, coverage types, enrollment periods, and available products and plans.
Cover the Financial Counseling call center and assist patients, families, community members, clinical departments, and Revenue Cycle departments with insurance coverage issues and questions.
Provide and document patient price estimate requests in accordance with federal price transparency regulations.
Use EPIC work queues to identify and contact uninsured or underinsured patients and screen them for assistance programs or upgrades to richer benefit coverage.
Coordinate with clinical areas, interpreters, social workers, case managers, outreach workers, benefit coordinators, physician offices, and community health centers to support access to care and timely discharge planning.
Discuss financial obligations with patients before elective procedures or admissions and communicate relevant information to provider offices and Revenue Cycle departments.
Update accounts with current financial class, eligibility dates, and other patient financial and demographic information.
Comply with departmental policies, procedures, objectives, health and safety requirements, and required training; attend meetings and demonstrate quality improvement in daily operations.
Maintain regular, reliable, and predictable attendance and perform other similar duties as required.