Patient Care Reimb Invest I

Commonwealth of Massachusetts•Tewksbury, MA

23d•Onsite

About The Position

The Department of Mental Health (DMH) is seeking a dynamic individual to serve as Patient Care Reimbursement Investigator (PCRI). The ideal candidate provides financial assistance to patients and the facility by ensuring that all entitlements and insurances are current to support the patient and assist the facility in billing. Please note: This position is full time, 40 hours per week 8:00am-4:30pm. Days off: Saturday-Sunday

Requirements

Minimum Entrance Requirements\: None
SPECIAL REQUIREMENTS\: Based on assignment, possession of a current and valid Massachusetts Motor Vehicle Operator's License may be required.
Title 101 CMR 23.00 (“Regulation”) requires certain agency staff to have received the COVID-19 vaccination and Influenza vaccination, or have taken required mitigation measures, to prevent viral infection and transmission in State Hospitals and State Congregate Care Facilities. The Regulation applies to this position. Successful candidates will be required to acknowledge and attest to your vaccination status for both COVID-19 and Influenza.

Nice To Haves

Given the population served, bilingual or multilingual fluency
Experience working with the mentally ill, behavioral challenged and disabled populations.
valid driver's license

Responsibilities

Works within the Department of Clinical Social Work Department assuming responsibility for all patient financial assistance, including but not limited to:
Meets with patients for purpose of gathering information and completing all relevant financial forms.
Works with patients to make application for SSI, Social Security, and General Relief benefits when appropriate and/or reinstating benefits that may have been in suspended status.
Works with patients and patient families to apply for all Medicaid /Mass health /Medicare coverage for hospital reimbursement; discharge planning, nursing home placement and/or general hospital admittance.
Research patient entitlements for financial assistance.
Communicates information to Department of Public Health (DPH) treasurer’s office that in turn bills for services as per regulations.
Provides DPH, Medicaid, Mass Health, Medicare etc. with appropriate forms to allow for billing in a timely manner as per regulations.
On an as needed basis, meets with DPH treasury staff and with CSW supervisory staff to ensure good communication and problem solve issues, which arise.
Participates in the planning and implementation of expenditures of various funds in consultation with the Treatment Teams, families and/or guardians.
Attends Morning Rounds to learn about new admissions and pending discharges and maintain current information re\: patient’s clinical status.
Attends treatment team meetings as needed for successful collaboration with patient and team related to patient’s request for funds and ability to manage funds.
Follows DMH guidelines as specified in DMH policy on Patient Funds #96-4, meeting all timeframes for assessments forms and documentation.
Provides ancillary supportive services to patients and families by performing routine liaison functions with relevant community agencies and Tewksbury Hospital departments to ensure patient access to appropriate financial and medical insurance benefits.
Communicates by phone and/or letter regularly with all relevant persons and agencies to ensure maximizing patient entitlement programs.
Monitors expenditures on behalf of all patients on assigned units by maintaining highly detailed records, bookkeeping and accounting functions for purpose of safe-guarding patients’ funds.
Works collaboratively with other PCRIs in the department to audit each other’s books as per policy and provide coverage during planned/unplanned absences.
Distributes and updates patient funds (from patient requisitions, Perry Fund, etc.) for provision of basic needs, including clothing and personal allowance in accordance with the patient’s budget.
Coordinates with providers, guardians, and representative payees, as needed, and may assist patients in shopping for personal needs.
May retain patient valuables, with appropriate documentation, to ensure safety or send to Tewksbury Hospital vault.
Responsible for acquiring necessary patient financial information to bill for services, conveying to Tewksbury Revenue Office and working efficiently and cooperatively with that department.
Will perform a limited amount of regularly scheduled, structured direct service as time allows, including a minimum of one psychoeducational group within the hospitals on unit rehabilitation program, to be determined by the supervisor.
Purchases items for patients, if necessary; with team and/or family approval as needed; maintains receipts and records.
May be required to produce reports and design forms for the Assistant Chief of Psychiatric Operations.
Required to develop skills with computer software related to financial and legal tracking and hospital medical record.
Other duties as assigned by the Assistant Chief of Psychiatric Operations.
Compliance with all applicable state and federal laws including the Health Insurance Portability and Accountability Act (HIPAA) regulations which governs the privacy and confidentiality of information about patients.