Outpatient Financial Counselor Quincy 24 Hours M-W 830AM-5P U

POSITION SUMMARY:

Under the general direction of PFC Manager the Quincy Outpatient Financial Counselor (OPFC) has a dual role to help vulnerable BMC patients to access healthcare coverage and to preserve and protect BMC revenue by securing payors to reduce uncompensated care. The Quincy OPFC serves as an advocate and navigator assisting low-income uninsured and underinsured patients apply for financial assistance programs and secure healthcare coverage. As a Certified Application Counselor the Quincy OPFC will respond to call center inquires and manage self-pay patient work ques to identify and contact patients in need of financial counseling services. The Quincy OPFC will engage patients by phone and/or in writing to screen for eligibility and provide enrollment assistance to secure insurance coverage through MassHealth Out of State Medicaid HSN or BMCs Charity Care Program. The Quincy OPFC is responsible for initiating new applications and assisting with program renewals; for educating patients about health insurance options and eligibility requirements; and for updating patient demographic information opening financial trackers and documenting all efforts made to assist patients in applying for insurance coverage. The Quincy OPFC will embody BMCs mission vision and values and follow policy and procedure regarding BMCs billing and collection practices and the Certified Application Counselor Designation Agreement between BMC and MassHealth.

Position: Outpatient Financial Counselor Quincy

Department: Financial Counseling

Schedule: Part Time 24 Hours M-W 8:30AM-5P U

ESSENTIAL RESPONSIBILITIES / DUTIES:

• Demonstrates respectful personal conduct and utilizes AIDET when engaging patients and visitors.
• Completes MassHealths curriculum for Certified Application Counselor and renews certification annually.
• Provides information about the full range of medical and dental insurance programs available through the Health Insurance Exchange (HIX).
• Interviews patients in a language and manner best understood to determine eligibility and communicate enrollment options and plan benefits for which patients qualify. Answers questions about Qualified Health Plans (QHP) and Qualified Dental Plans (QDP). Explains subsidized Qualified Health Plans available through premium tax credits or informs patients of expected out-of-pocket expenses co-pays and deductibles when applicable.
• Utilizes protected software programs to determine patient eligibility for MassHealth Health Safety Net ConnectorCare and other insurance carriers and assists with enrollment process.
• Initiates communication with patients by phone mail or email to initiate new applications or plan renewals for health insurance coverage. Informs patients of important deadlines effective dates for coverage and required documentation to determine eligibility.
• Scans MassHealth applications and supporting verification documents into HIX and patients Epic record.
• Documents in Epic the status of all applications initiated by adding a financial tracker and recording actions taken and follow-up efforts required to complete and submit for processing.
• As requested assists patients with enrolling in an ACO or changing selection of ACO to ensure continued access to covered services.
• Provides voter registration information and registration assistance as needed; completes appropriate patient declination form for applicants as requested.
• Validates and updates active insurance coverage in the hospital registration and billing system on accounts with covered dates of service.
• Assists patients with billing questions or concerns. For patients deemed ineligible for financial assistance programs provides information regarding self-pay discount and payment plan options.
• Collects and posts payments for balances related to self-pay Ad-Hoc and Flat Fee contracts in accordance with BMC policy and procedure for collection practices.
• Interacts with numerous departments to resolve insurance and billing questions e.g. Customer Service Pharmacy Social Service Case Management Patient Accounts Clinic Staff Unit Nursing staff professional billing etc.
• Provides pricing estimates for elective services as requested if patient is uninsured or if services are uncovered by payor.
• Understands and adheres to rules established by the BMC Credit and Collection Policy.
• Assists patients with confidential applications for protected services adding account notes to notify others of the patients protected status.
• Assists patients with medical hardship and confidential applications obtaining and submitting verification documents and applicable medical bills required to apply and make a determination of eligibility.
• Responds to telephone calls in a courteous manner. Responds promptly to all inquiries from staff patients and general public. As needed refers callers to other departments or resources deemed appropriate for resolution.
• Presents and interacts respectfully and professionally with BMC patients visitors and other team members; works cooperatively and respectfully with other departments and disciplines across the organization.
• Maintains daily written reports of work activity to document patient enrollments and outcomes; patient complaints and resolutions; patient declinations etc.
• Demonstrates superior customer service standards.
• Participates in regular staff meetings and scheduled trainings to maintain required core competencies.
• Serves as a resource and subject matter expert regarding financial assistance programs. Provides education and advisement on health insurance options and enrollment requirements for other hospital departments community health centers community leaders and other personnel as needed.
• Under the direction of PFC Manager assists with the orientation including shadowing of new staff as assigned.
• Validates and/or updates demographic and income information in HIX portal for known patients with prior history of program eligibility.
• Validates patients active insurance coverage and updates current plans in Epic.
• Collects and posts payments on accounts with outstanding balances. Maintains and closes Epic Cash Drawer and documents transactions in patients financial trackers.
• Schedules tasks for Financial Counseling Enrollment Coordinators (FCECs) to conduct patient follow-up on pending applications to ensure that required documents are obtained and applications are completed and submitted timely to secure retroactive coverage.
• Protects patient and family confidentiality.
• Performs other duties and tasks as assigned.

JOB REQUIREMENTS

EDUCATION:

High School diploma with 3-5 years of strong customer service experience in healthcare or human services setting required; Bachelors degree strongly preferred. Bilingual persons and persons with hospital and/or healthcare experience strongly preferred.

CERTIFICATES LICENSES REGISTRATIONS REQUIRED:

Must complete MassHealths curriculum for Certified Application Counselor (CAC) and maintain certification renewal annually. Individual must complete training and obtain CAC certification within 45 days of hire date.

EXPERIENCE:

Work experience to include 2-3 years of strong customer service experience preferably in a healthcare or human services setting; Bachelors degree strongly preferred. Bilingual persons and persons with hospital and/or healthcare experience strongly preferred.

KNOWLEDGE AND SKILLS:

• Demonstrates professionalism maturity and confidence needed to work effectively in a diverse multi-cultural and decentralized environment.
• Displays strong consistent communication skills (oral and written) interpersonal skill and record keeping skills.
• Demonstrates knowledge and understanding of eligibility criteria and application process for programs offered through MassHealth Health Safety Net ConnectorCare and BMCs Charity Care Program.
• Displays strong organizational skills with ability to manage multiple tasks simultaneously; prioritize work assignments appropriately; and complete follow up task timely.
• Demonstrates strong work ethic and ability to meet performance goals for productivity and outcomes with minimal direct supervision.
• Demonstrates critical thinking and sound judgment in addressing and resolving barriers issues or concerns identified.
• Requires strong technical computer skills and proficiency in utilizing Epic and external database systems to research cases and successfully assist patients in securing active coverage.
• Displays exceptional customer skills and the ability to engage patients family members and team members respectfully with empathy and cultural sensitivity.

Equal Opportunity Employer/Disabled/Veterans

According to the FTC there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications or apps job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.