Ambulatory Financial Counselor / 40 Hour / Day / BWH Southern Jamaica Plain Health Center

As a "Certified Application Counselor" (CAC), the financial counselor works primarily with uninsured and underinsured patients to conduct in-depth and detailed evaluation of patient financial history for the purpose of determining eligibility for financial assistance programs. The financial counselor guides the patient regarding the process for determining the most appropriate form of financial assistance and assists in the application process, acting as the patient representative. Programs considered are MassHealth, Qualified Health Plan via the Health Connector, Children's Medical Security Plan, Senior Pharmacy Programs, Health Safety Net (HSN), and other programs as appropriate, including annual Medicare pharmacy enrollment. Additionally, helps clients understand their financial liabilities with commercial plans including co-payments, deductibles, and co-insurance.
The financial counselor also verifies insurance, networks, collect payments, performs third party verification including motor vehicle and worker's compensation, and assist patients by establishing payment plans. The financial counselor provides Voter Registration assistance to qualifying individuals. Additionally, provides oversight of cash control processes and performs daily deposits. In addition to fiscal responsibilities, the financial counselor also serves as the registration subject matter expert for new and ex.
Explains the role of a CAC and assists uninsured and underinsured patients with financial assistance, including screening for eligibility for Medicaid, Health Connector, or other government programs, assisting patients in completing Medicaid or HSN applications and renewals. Acquaints patients with the hospital's financial policies and requirement.
Submits completed Medicaid applications and renewals to the Massachusetts Division of Medical Assistance. Follows-up on all submitted applications, assuring compliance, and acts as a liaison between patients, health center staff and government agencies in an effort to obtain approvals in a timely manner.
Assist patients with voting registration when applicable, while completing required forms such as the Declination Form, and Permission to Share Information (PSI) form.
Screens and assesses the ability of patients to pay for services. Uses computer systems and applicable documents to ensure all free care eligibility data. Re-bills as necessary in collaboration with billing department.
Keeps CAC certification active by adhering to state training requirements via Learning Management System. Ensures others CAC's are up-to-date on training requirements.
The financial counselor:
works closely with BWH departments (accounts receivable, ambulatory registration, care coordination, admitting, legal, etc.) to indicate patients' insurance status and to resolve patient account issues.
provides assistance to patients in researching outstanding accounts and troubleshoots problems with billing questions within the accounts receivable system.
arranges payment plans with patients and billing office.
ensures information is available for Medicaid tracking and reporting, and ensures data integrity.
In addition, the financial counselor:
registers new or existing patients for visits
provides new patient orientation including Privacy/ HIPAA overview and acknowledgement, and consent forms
verifies patient insurance for visits
collects and document all payments
oversees daily deposits and completes weekly accounts receivable processes
have responsibility for cash drawer
reviews upcoming new patient appointments to ensure financial clearance.
connects with new patient coordinator if issues arise.
Performs other duties as assigned.
Bachelor's degree or equivalent preferred; high school diploma or GED required. Proven experience in a like setting is acceptable in lieu of educational requirements.
1-2 years experience working with government entitlement programs (e.g., Medicaid) or in third party billing preferred.
Knowledge of eligibility requirements for Federal, state and local programs providing reimbursement for health care services preferred.
Bilingual, as appropriate to work site, (English/Spanish) required.
Familiarity with state programs, policy and procedures preferred.
Familiarity with hospital credit and collection policy and procedures preferred.
Knowledge of all insurance carriers, including coverage, referral requirements, and co-payments.
Organized and able to set and carry through on work priorities.
Ability to work independently, and to work as part of a team.
Good judgment, tact, sensitivity, and the ability to maintain confidentiality.
Good interpersonal and customer service skills.
Comprehensive computer skills.

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