[Hiring] Outpatient Financial Counselor @BMC Software

Role Description

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 inquiries and manage self-pay patient work queues.
• Engage patients, by phone and/or in writing, to screen for eligibility and provide enrollment assistance.
• Educate patients about health insurance options and eligibility requirements.
• Update patient demographic information, open financial trackers, and document all efforts made to assist patients.

The Quincy 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.

Qualifications

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

Requirements

• 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.
• Work experience to include 2-3 years of strong customer service experience, preferably in a healthcare or human services setting.

Benefits

• Compensation Range: $25.25 - $30.78.
• Generous total compensation that includes benefits (medical, dental, vision, pharmacy).
• Contract increases, Flexible Spending Accounts, 403(b) savings matches.
• Earned time cash out, paid time off, career advancement opportunities.
• Resources to support employee and family wellbeing.

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.
• Explains subsidized Qualified Health Plans available through premium tax credits.
• Utilizes protected software programs to determine patient eligibility for various insurance carriers.
• Initiates communication with patients to initiate new applications or plan renewals.
• Scans MassHealth applications and supporting verification documents into HIX and patients’ Epic record.
• Documents in Epic the status of all applications initiated.
• Assists patients with enrolling in an ACO or changing selection of ACO.
• Provides voter registration information and registration assistance as needed.
• Validates and updates active insurance coverage in the hospital registration and billing system.
• Assists patients with billing questions or concerns.
• Collects and posts payments for balances related to self-pay, Ad-Hoc, and Flat Fee contracts.
• Interacts with numerous departments to resolve insurance and billing questions.
• Provides pricing estimates for elective services, as requested.
• 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.
• Participates in regular staff meetings and scheduled trainings.
• Serves as a resource and subject matter expert regarding financial assistance programs.
• Validates and/or updates demographic and income information in HIX portal.
• Collects and posts payments on accounts with outstanding balances.
• Maintains and closes Epic Cash Drawer and documents transactions.
• Schedules tasks for Financial Counseling Enrollment Coordinators (FCECs).
• Protects patient and family confidentiality.
• Performs other duties and tasks as assigned.