Outpatient Financial Counselor U

Company: Boston Medical Center
Location: Boston
Posted on: March 26, 2025

Job Description:

Outpatient Financial Counselor UOutpatient Financial CounselorLocation: BostonTime Type: Full timePosted On: 18 Days AgoJob Requisition ID: 40553Department: Financial CounselingSchedule: Full Time, Yawkey Building & Menino PavilionPOSITION SUMMARY:Under the general direction of PFC Manager, the Outpatient Financial Counselor (OPFC) has a dual role to help vulnerable BMC patients access healthcare coverage and to preserve BMC revenue by securing payors to reduce uncompensated care. The OPFC serves as an advocate and navigator, assisting low-income, uninsured and underinsured patients in applying for financial assistance programs and securing healthcare coverage. As a Certified Application Counselor, the OPFC will assist patients referred for financial counseling, in person or by phone, from PFC office locations on the hospital campus. Patients presenting for services, by appointment or walk-in, will be screened for eligibility and offered enrollment assistance to secure insurance coverage through MassHealth, Out of State Medicaid, HSN, or BMC's Charity Care Program. The OPFC is responsible for initiating new applications and assisting with program renewals; 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 OPFC will embody BMC's mission, vision, and values and follow policy and procedure regarding BMC's billing and collection practices and the Certified Application Counselor Designation Agreement between BMC and MassHealth.JOB REQUIREMENTSEDUCATION:High School diploma or GED, plus three (3) or more years of related customer service experience in healthcare or in a human services setting required.CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:Must complete MassHealth's 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 two (2) or more years of related customer service experience, preferably in a healthcare or in a human services setting.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 skills, and record keeping skills.
• Demonstrates knowledge and understanding of eligibility criteria and application process for programs offered through MassHealth, Health Safety Net, ConnectorCare, and BMC's Charity Care Program.
• Displays strong organizational skills with ability to manage multiple tasks simultaneously; prioritize work assignments appropriately; and complete follow-up tasks 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.ESSENTIAL RESPONSIBILITIES / DUTIES:
  • Demonstrates respectful personal conduct and utilizes AIDET when engaging patients and visitors.
  • Completes MassHealth's 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 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).
  • Utilizes protected software programs to determine patient eligibility for MassHealth, Health Safety Net, ConnectorCare, and other insurance carriers and assists with the enrollment process.
  • Provides in-person assistance at PFC office locations in Yawkey and Shapiro buildings, to offer outreach and education or initiate new applications or plan renewals for health insurance coverage.
  • 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.
  • 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.
  • 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.
  • 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.
  • Understands and adheres to rules established by the BMC Credit and Collection Policy.
  • Assists patients with confidential applications for protected services.
  • Responds to telephone calls in a courteous manner.
  • Presents and interacts respectfully and professionally with BMC patients, visitors, and other team members.
  • Maintains daily written reports of work activity to document patient enrollments and outcomes.
  • 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.
  • Validates and/or updates demographic and income information in HIX portal for "known" patients with prior history of program eligibility.
  • Collects and posts payments on accounts with outstanding balances.
  • Schedules tasks for Financial Counseling Enrollment Coordinators (FCECs) to conduct patient follow-up on pending applications.
  • Protects patient and family confidentiality.
  • Performs other duties and tasks as assigned.Equal Opportunity Employer/Disabled/VeteransOur PeopleWorking at Boston Medical Center is more than a job. It's a chance to make a difference as part of our mission to provide exceptional and equitable care to all.EEO & Accommodation StatementBoston Medical Center is an equal employment/affirmative action employer. We ensure equal employment opportunities for all, without regard to race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity and/or expression or any other non-job-related characteristic.RequirementsBoston Medical Center participates in the Electronic Employment Verification Program. As an E-Verify employer, prospective employees of BMC must complete a background check before beginning their employment at the hospital. BMC requires all staff to be vaccinated against COVID-19 and flu.
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Keywords: Boston Medical Center, Boston , Outpatient Financial Counselor U, Accounting, Auditing , Boston, Massachusetts