Patient Financial Services Counselor (On-Site)

Beth Israel Lahey Health•Peabody, MA

4d•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-related financial matters. The role focuses on billing concerns, insurance options and benefits, coverage gaps, and payment options. The counselor also assists with patient statements, payment plans, pricing estimates, Financial Assistance, Federal and State benefits, and managed care processes. The position supports Patient Access and Hospital and Professional Billing, working in conjunction with Customer Service. The role is under the direct supervision of the Supervisor of Financial Counseling and the leadership of the Manager of Financial Counseling. The counselor assists patients by phone or in person, explains insurance policies and Explanation of Benefits, helps resolve financial concerns with departments and providers, and supports coverage coordination for patients who need it. Responsibilities also include providing service estimates, collecting payments, educating and enrolling eligible patients in payment plans, screening patients for Financial Assistance, supporting MassHealth/Medicaid applications, and addressing managed care concerns. The counselor follows financial counseling, cash, collection, compliance, and customer service policies and standards. The position requires a high school diploma. A Certified Application Counselor certification is preferred, as is experience in financial counseling, social work, case work, patient access, or billing. CPC certification and EPIC experience are also preferred. The posted base hourly pay range is $21.53–$28.98. Beth Israel Lahey Health requires staff to be vaccinated against influenza as a condition of employment.

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.
Demonstrate tact, diplomacy, and discretion.
Ability to multitask and work in a fast-paced, detail-oriented environment.
Working knowledge of the MS Office suite and database systems, with the ability to learn new systems.
If any listed skills are lacking, demonstrate the ability to be thoroughly trained to meet organizational standards.
Must be vaccinated against influenza as a condition of employment.

Nice To Haves

Certified Application Counselor (CAC) certification is preferred.
Two to three years of experience in financial counseling, social work, case work, patient access, or billing is preferred.
General understanding of hospital and professional billing procedures.
Certified Professional Coder (CPC) certification is a plus.
EPIC system experience is preferred.

Responsibilities

Maintain annual Certified Application Counselor certification for the state of Massachusetts.
Assist patients by phone or in person with financial matters and concerns, and discuss and document issues related to collection notices, statements, billing, or insurance.
Help patients understand their Explanation of Benefits, insurance policies, and covered services.
Work with departments and providers across the organization to resolve patient financial concerns, including those involving elective, plastic, low-coverage, or non-covered medically urgent procedures.
Coordinate services with outside stakeholders to help provide necessary coverage for patients requiring enhanced coordination of benefits because of disabilities.
Follow established protocols to ensure appropriate financial counseling actions are taken and communicate with departments before scheduling procedures that will not be covered by insurance.
Provide timely service estimates to patients orally or in writing in compliance with CMS price transparency regulations.
Collect self-pay patient payments, including pre-payments, outstanding balances, copayments, deductibles, and out-of-pocket expenses, in accordance with PFS policies and procedures.
Educate and enroll qualified patients in payment plans for outstanding or anticipated balances according to leadership guidelines.
Screen and approve patients for Financial Assistance in accordance with the Financial Assistance Policy.
Visit inpatients or patients in outpatient clinics, when appropriate, to discuss coverage applications and payment options.
Support patients with MassHealth/Medicaid Open Enrollment by providing education and processing necessary 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.
Work on assigned projects.
Adhere to corporate and governmental compliance requirements and Cash and Collection Policies and Procedures.
Follow Customer Service standards to provide exceptional patient service.