Lead Financial Counselor-MSHAR

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Exemption Status:

Non-Exempt

Hiring Range:

$19.53 - $32.06 (based on a full time schedule of 40 hours per week).

Please note that the final offer will vary based on scheduled hours. Compensation for part-time or reduced schedules will be prorated based on scheduled weekly hours, experience, skills, qualifications, and internal equity considerations.

Schedule Details:

Monday through Friday

Scheduled Hours:

8:00 AM - 4:30 PM

Shift:

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

Hours:

40

Cost Center:

10021 - 5640 Patient Accounting

Union:

SHARE Marlborough

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 20,000 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 Lead Financial Counselor (Certified Application Counselor) provides functional oversight to an assigned group of Financial Counselors for the process of providing health care coverage needs assessment with patients, community applicants, and family members.

• I. Major Responsibilities:
• 1. Responsible for distributing and monitoring the flow of work for an assigned group of Financial Counselors.
• 2. Prioritizes work in high volume, fast paced, team-oriented environment.
• 3. 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.
• 4. 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.
• 5. Interacts with patients, the community, and outside agencies in a professional manner in keeping with the Mission and Vision of UMMHC.
• 6. 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.
• 7. 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.
• 8. 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.
• 9. 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.
• 10. 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.
• 11. Provides and documents price estimates request to patients in accordance with federal price transparency regulations.
• 12. 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.
• 13. 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.
• 14. Discusses financial obligations with patients prior to elective surgical days or admissions. Communicates all information to provider offices and other Revenue Cycle departments.
• 15. 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. Distributes and monitors the flow of work for an assigned group of employees. Provides training and technical assistance to employees within the assigned work area. Assists supervisor in assuring that assigned employees are provided with appropriate resources, materials, and methods. Provides recommendations to manager or supervisor for the most efficient utilization of assigned personnel. Relays work instruction from the supervisor. Provides direction, guidance and leadership in the absence of the supervisor.
• 2. Complies with established departmental policies, procedures and objectives.
• 3. Attends variety of meetings, conferences, seminars as required or directed.
• 4. Demonstrates use of Quality Improvement in daily operations.
• 5. Complies with all health and safety regulations and requirements.
• 6. 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.
• 7. Maintains, regular, reliable, and predictable attendance.
• 8. Performs other similar and related duties as required or directed.
• All responsibilities are essential job functions.

II. Position Qualifications:

• License/Certification/Education:
• Required:
• 1. Associates Degree in Business, Social Services or three years’ experience in healthcare, accounts receivable or related function.
• 2. Certified Application Counselor (CAC)certification.
• 3. 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.

• Experience/Skills:
• Required:
• 1. 3 years’ experience in healthcare, accounts receivable, Financial Counseling, medical billing, or a related field.
• 2. Proficient in department collection practices and concepts of third party, bad debt and free care regulations.
• 3. Excellent written and verbal communication skills in order to communicate effectively with a variety of levels including patients, hospital, and medical staff.
• 4. Effective communication and customer service skills both verbal and written.
• 5. Ability to use specialized applications software and computers systems for patient registration and scheduling.
• 6. Ability to work independently with strong problem resolution skills.
• 7. 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.

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.

III. Physical Demands and