Financial Counselor-SHARE

UMass Memorial Health•Worcester, MA

23h•$22 - $32•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 counselor determines eligibility for MassHealth, Qualified Health Plans, Children’s Health Insurance, the Health Safety Net, and other available coverage, and provides guidance about financial assistance programs to patients, UMass staff, physician offices, and third-party vendors. The role includes interviewing and screening applicants, helping them understand coverage options, facilitating enrollment, following up on incomplete applications, resolving eligibility issues with external agencies, and supporting patients and families through the application process. The counselor also provides price estimates, works EPIC work queues to identify uninsured or underinsured people who may qualify for assistance, discusses financial obligations before elective procedures or admissions, and updates accounts with current eligibility and demographic information. This is a non-exempt, 40-hour-per-week position scheduled Monday through Friday, 8:00 AM to 4:30 PM. Work is considered light, involves frequent walking, and takes place indoors in a normal office and/or patient care environment.

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 privacy and security regulations meeting 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 application 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.
Ability to 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 eligibility criteria in accordance with CMS and government guidelines.
Determine eligibility for affordable health 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.
Follow up in person or by telephone to obtain confidential financial and medical information needed to complete applications and establish program eligibility.
Act as a liaison with MassHealth, the Health Connector, and the Health Safety Net to resolve eligibility discrepancies, check application status, and address other determination 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 coverage questions and issues.
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 possible coverage upgrades.
Coordinate with clinical areas, interpreters, social workers, case managers, outreach workers, care teams, 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 other Revenue Cycle departments.
Update accounts to reflect 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 and training; and apply quality improvement practices in daily work.
Demonstrate professionalism, respect, and reliable attendance, perform other related duties as directed, and contribute to a respectful and inclusive environment.