Patient Financial Counselor

UMass Memorial Health•Milford, MA

12d•$17 - $31•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) provides a key role in providing a health care coverage needs assessment with patients, community applicants, and family members. Determines eligibility for MassHealth, Qualified Health Plans, Children’s Health Insurance, Health Safety net and any other coverage that they may qualify. Provides guidance and assistance to patients, various internal UMass staff, physician offices and third-party vendors regarding financial assistance programs.

Requirements

High School Graduate.
Certified Application Counselor (CAC)certification required within 45 days of hire as a condition of employment.
Completes annual recertification and all mandatory ongoing training provided by the Massachusetts on-line Learning Management System and complies with privacy and security regulations that meet all federal program standards.
Previous experience in healthcare, accounts receivable, Financial Counseling, medical billing, or a related field.
Proficient data-entry and strong organization skills with attention to detail.
Effective communication and customer service skills both verbal and written.
Ability to use specialized applications software and computers systems for patient registration and scheduling.
Ability to work independently with strong problem resolution skills.
Must provide own transportation.
Ability to prioritize and work in high volume, fast paced, team-oriented environment.
Ability to take directions and work independently.
English speaking, reading and writing skills

Nice To Haves

Associate or bachelor’s degree in Business, Social Services or related field.
Bilingual speaking, reading.

Responsibilities

Interviews, screens and assess applicants and family members in a variety of on campus locations utilizing income and household composition and other criteria in accordance with CMS and other governmental established guidelines for program eligibility.
Determines qualification for affordable health insurance coverage, including the application of advance premium tax credits (APTC), premium assistance programs, Medicare Savings Plans and any other program they may be determined eligible.
Interacts with patients, the community, and outside agencies in a professional manner in keeping with the Mission and Vision of UMMHC.
Facilitates enrollment through the online Health Connector Health Insurance Exchange (HIX) or any other program application by accurate and timely submission of necessary paperwork according to state and federal regulations and policies.
Follows up with patients in person or by telephone to obtains appropriate confidential financial and medical information on incomplete applications.to establish eligibility for various financial assistance programs.
Acts as the liaison for patients with MassHealth, the Health Connector and the Health Safety Net to assist in the resolution of eligibility discrepancies, applications status updates, and any other issue that may arise in the determination process.
Facilitates patient understanding of health access options including but not limited to eligibility rules, coverage types, enrollment periods, products and plans available through MassHealth, the Health Connector, Medicaid Managed Care, and the Health Safety Net program.
Responsible for coverage of the Financial Counseling call center to act as a resource for patients and families, members of the community, clinical departments and other Revenue Cycle departments with insurance coverage issues and questions.
Provides and documents price estimates request to patients in accordance with federal price transparency regulations.
Works within EPIC work queues to identify and reach out to uninsured/underinsured patients/families (inpatient, outpatient, surgical day, psychiatric in patients, psychiatric outpatients, etc.) for the purpose of screening for assistance programs and upgrades to a richer benefit program.
Works in conjunction with clinical areas, interpreters, social workers, case managers, social security outreach workers, drug assistance coordinator, enhanced benefit coordinator, care mobile, physician/provider offices and community health centers as needed to ensure access to care and timely discharge planning.
Discusses financial obligations with patients prior to elective surgical days or admissions. Communicates all information to provider offices and other Revenue Cycle departments.
Updates all accounts to reflect the current account status with appropriate financial class, eligibility dates, other patient financial and demographic information.
Complies with established departmental policies, procedures and objectives.
Attends variety of meetings, conferences, seminars as required or directed.
Demonstrates use of Quality Improvement in daily operations.
Complies with all health and safety regulations and requirements.
Respects diverse views and approaches, demonstrates Standards of Respect, and contributes to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors.
Maintains, regular, reliable, and predictable attendance.
Performs other similar and related duties as required or directed.