Patient Financial Counselor
Patient Financial Counselor
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1 Vacancy
Job Description
Are you an internal caregiver student or contingent worker/agency worker at UMass Memorial Health CLICK HERE to apply through your Workday account.
Exemption Status:
NonExemptSchedule Details:
Monday through FridayScheduled Hours:
8:00 AM to 4:30 PMShift:
1 Day Shift 8 Hours (United States of America)Hours:
40Cost Center:
Financial CounselingThis position may have a signing bonus available a member of the Recruitment Team will confirm eligibility during the interview process.
Everyone Is a Caregiver
At UMass Memorial Health everyone is a caregiver regardless of their title or responsibilities. Exceptional patient care academic excellence and leadingedge research make UMass Memorial the premier health system of Central Massachusetts and a place where we can help you build the career you deserve. We are more than 16000 employees working together as one health system in a relentless pursuit of healing for our patients community and each other. And everyone in their own unique way plays an important part every day.
Under the general direction of the Financial Counseling Supervisor/Manager and/or FinancialClearance 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 Childrens 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 thirdparty vendors
regarding financial assistance programs.
Major Responsibilities:
1. 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.
2. 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.
3. Interacts with patients the community and outside agencies in a professional manner in
keeping with the Mission and Vision of UMMHC.
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.
9. Provides and documents price estimates request to patients in accordance with federal price
transparency regulations.
10. 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.
11. 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.
12. Discusses financial obligations with patients prior to elective surgical days or admissions.
Communicates all information to provider offices and other Revenue Cycle departments.
13. Updates all accounts to reflect the current account status with appropriate financial class
eligibility dates other patient financial and demographic information.
Standard Staffing Level Responsibilities:
1. Complies with established departmental policies procedures and objectives.
2. Attends variety of meetings conferences seminars as required or directed.
3. Demonstrates use of Quality Improvement in daily operations.
4. Complies with all health and safety regulations and requirements.
5. 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.
6. Maintains regular reliable and predictable attendance.
7. Performs other similar and related duties as required or directed.
All responsibilities are essential job functions.
III. Position Qualifications:
License/Certification/Education:
Required:
1. High School Graduate.
2. Certified Application Counselor (CAC)certification required within 45 days of hire as a
condition of employment.
3. Completes annual recertification and all mandatory ongoing training provided by the
Massachusetts online Learning Management System and complies with privacy and
security regulations that meet all federal program standards.
Preferred:
1. Associate or bachelors degree in Business Social Services or related field.
Experience/Skills:
Required:
1. Previous experience in healthcare accounts receivable Financial Counseling medical
billing or a related field.
2. Proficient dataentry and strong organization skills with attention to detail.
3. Effective communication and customer service skills both verbal and written.
4. Ability to use specialized applications software and computers systems for patient
registration and scheduling.
5. Ability to work independently with strong problem resolution skills.
6. Must provide own transportation.
7. Ability to prioritize and work in high volume fast paced teamoriented environment.
8. Ability to take directions and work independently.
9. English speaking reading and writing skills
Preferred:
1. Bilingual speaking reading.
Unless certification licensure or registration is required an equivalent combination of education
and experience which provides proficiency in the areas of responsibility listed in this description
may be substituted for the above requirements.
Departmentspecific competencies and their measurements will be developed and maintained in
the individual departments. The competencies will be maintained and attached to the departmental
job description. Responsible managers will review competencies with position incumbents.
IV. Physical Demands and Environmental Conditions:
Work is considered light with frequent walking throughout the day. Position requires work
indoors in a normal office and/or patient care environment.
The Organization reserves the right to modify position duties at any time.
All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity national origin disability or protected veteran status.
Were striving to make respect a part of everything we do at UMass Memorial Health for our patients our community and each other. Our six Standards of Respect are: Acknowledge Listen Communicate Be Responsive Be a Team Player and Be Kind. If you share these Standards of Respect we hope you will join our team and help us make respect our standard for everyone every day.
As an equal opportunity and affirmative action employer UMass Memorial Health recognizes the power of a diverse community and encourages applications from individuals with varied experiences perspectives and backgrounds. All qualified applicants will receive consideration for employment without regard to race color religion gender sexual orientation national origin age disability gender identity and expression protected veteran status or other status protected by law.
If you are unable to submit an application because of incompatible assistive technology or a disability please contact us at We will make every effort to respond to your request for disability assistance as soon as possible.
Employment Type
Full-Time
