Financial Counselor-Marlborough
About The Position
The Financial Counselor (Certified Application Counselor) assesses healthcare coverage needs for patients, community applicants, and family members. The role determines eligibility for MassHealth, Qualified Health Plans, Children’s Health Insurance, the Health Safety Net, and other coverage programs, and provides guidance and assistance to patients, UMass staff, physician offices, and third-party vendors regarding financial assistance programs. The Financial Counselor screens applicants using income, household composition, and other criteria under applicable governmental guidelines; facilitates enrollment and follows up on applications; helps resolve eligibility issues; and explains coverage options. The role also supports the Financial Counseling call center, provides price estimates, works in EPIC work queues to identify uninsured or underinsured patients, discusses financial obligations, and updates account information. The position works with clinical and community partners to support access to care and timely discharge planning. The role is under the general direction of the Financial Counseling Supervisor/Manager and/or Financial Clearance Director. Work is indoors in a normal office and/or patient care environment and is considered light, with frequent walking throughout the day.
Requirements
- High school graduate.
- 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 applicable 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.
Nice To Haves
- Associate or bachelor’s degree in Business, Social Services, or a related field.
- Bilingual speaking and reading skills.
Responsibilities
- Interview, screen, and assess applicants and family members using income, household composition, and other criteria in accordance with CMS and other governmental eligibility guidelines.
- Determine qualification for affordable health insurance coverage, including advance premium tax credits, premium assistance programs, Medicare Savings Plans, and other eligible programs.
- Interact professionally with patients, community members, and outside agencies in keeping with the organization’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 regulations and policies.
- Follow up with patients in person or by telephone to obtain confidential financial and medical information needed to complete applications and establish eligibility.
- Serve as a liaison with MassHealth, the Health Connector, and the Health Safety Net to resolve eligibility discrepancies, provide application-status updates, and address other determination issues.
- Explain health access options, eligibility rules, coverage types, enrollment periods, and products and plans available through MassHealth, the Health Connector, Medicaid Managed Care, and the Health Safety Net.
- 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 requested price estimates in accordance with federal price transparency regulations.
- Use EPIC work queues to identify and contact uninsured or underinsured patients and families to screen for assistance programs and potential upgrades to richer benefit programs.
- Coordinate with clinical areas, interpreters, social workers, case managers, outreach workers, coordinators, care mobile, provider offices, and community health centers to support access to care and timely discharge planning.
- Discuss financial obligations with patients before elective surgical days or admissions and communicate relevant information to provider offices and Revenue Cycle departments.
- Update accounts with current account status, financial class, eligibility dates, and other patient financial and demographic information.
- Comply with departmental policies, procedures, objectives, and health and safety requirements; attend required meetings, conferences, and seminars; and use quality improvement in daily operations.
- Demonstrate respect and professionalism toward employees, patients, and visitors, maintain regular and reliable attendance, and perform other similar duties as required or directed.
Benefits
- A signing bonus may be available; eligibility will be confirmed by a member of the Recruitment Team during the interview process.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
