Patient Financial Services Counselor (On-Site)

Beth Israel Lahey Health•Peabody, MA

6d•$22 - $29•Onsite

About The Position

The Patient Financial Services Counselor acts as a liaison between patients and the health system, providing guidance and support on healthcare financial matters. The role focuses on billing concerns, insurance options and benefits, coverage gaps, payment options, patient statements, payment plans, pricing estimates, financial assistance, federal and state benefits, and managed care. The position supports Patient Access and Hospital and Professional Billing areas and works with Customer Service. The counselor works under the direct supervision of the Supervisor of Financial Counseling and the leadership of the Manager of Financial Counseling. The role requires maintaining annual Certified Application Counselor certification for Massachusetts, following financial counseling, cash, collection, and compliance policies, and delivering exceptional patient service.

Requirements

High school diploma.
Maintain annual Certified Application Counselor certification for the state of Massachusetts.
Excellent customer service skills.
Excellent written and oral communication and interpersonal skills.
Tact, diplomacy, and discretion at all times.
Ability to multitask and work in a fast-paced, detail-oriented environment.
Working knowledge of the Microsoft Office suite and database systems, with the ability to learn new systems.
If any listed skills are absent, demonstrate the ability to be thoroughly trained to meet organizational standards.

Nice To Haves

Certified Application Counselor (CAC) certification is preferred.
Certified Professional Coder (CPC) certification is a plus.
Two to three years of experience in Financial Counseling, Social Work, Case Work, Patient Access, or Billing.
General understanding of hospital and professional billing procedures.
EPIC system experience.

Responsibilities

Maintain annual Certified Application Counselor certification for the state of Massachusetts.
Assist patients over the phone or in person with financial matters and concerns, and document issues related to collection notices, statements, billing, or insurance.
Help patients understand Explanation of Benefits documents, insurance policies, and covered services.
Work with departments and providers to resolve patient financial concerns, including those involving elective, plastic, low-coverage, or non-covered medically urgent procedures.
Coordinate with outside stakeholders to arrange necessary coverage for patients who need enhanced coordination of benefits due to disabilities.
Follow established protocols for financial counseling and communicate with departments before scheduling procedures that will not be covered by insurance.
Provide timely oral or written service estimates in compliance with CMS price transparency regulations.
Collect self-pay patient payments, including prepayments, outstanding balances, copayments, deductibles, and out-of-pocket expenses, according to PFS policies and procedures.
Educate eligible patients about payment plans and help enroll them for outstanding or anticipated balances.
Screen and approve patients for Financial Assistance (Charity) according to policy guidelines.
Visit inpatients and outpatient clinic patients, when appropriate, to discuss coverage applications and payment options.
Support patients with MassHealth/Medicaid Open Enrollment by providing education and processing applications.
Address managed care concerns for patients who need assistance.
Work with Customer Service to resolve financial issues, including account adjustments, statement generation, and billing errors.
Complete projects as assigned.
Follow corporate and governmental compliance requirements and Cash and Collection Policies and Procedures.
Adhere to Customer Service standards and provide exceptional patient service.