Patient Financial Counselor

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:

Non-Exempt

Schedule Details:

Monday through Friday

Scheduled Hours:

8:00 AM to 4:30 PM

Shift:

1 - Day Shift, 8 Hours (United States of America)

Hours:

40

Cost Center:

25080 - 5428 Financial Counseling

This 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 leading-edge 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 16,000 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 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.

Major 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.

Standard Staffing Level Responsibilities:

• 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.
  
  

III. Position Qualifications:

All responsibilities are essential job functions.

License/Certification/Education:

Required:

• 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.

Preferred:

• Associate or bachelor’s degree in Business, Social Services or related field.
  
  

Experience/Skills:

Required:

• 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
  
  

Preferred:

• 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.

Department-specific 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.

We’re 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 talentacquisition@umassmemorial.org. We will make every effort to respond to your request for disability assistance as soon as possible.