Job Description

Under the direction of the Manager of Patient Access, identify and coordinate assistance to underinsured and uninsured patients through screening and referral to MassHealth Counselors or Patients Accounts. Collect deposits for patient liability as applicable.

Key Responsibilities:

• Review and troubleshoot all accounts to determine accuracy and patient eligibility for state/federal insurance programs.
• Monitor and execute all “UR” changes in the computer system. Act on changes in a timely manner. Provide the necessary notification to HIS, BAR, physician, insurance companies, and nursing floors.
• Correct patient registration and account information in a timely manner to ensure accurate billing and reimbursement.
• Investigate and pursue all sources (i.e., physician, nursing home, employers, relative etc.) of information to determine insurance or other liability coverage.
• Utilize all available payer systems and vehicles, i.e., website, fax, and telephone, for eligibility company.
• Enter BAR notes to reflect all insurance verification activities and outcomes. Review patient registration and account details for effective insurance verification processing.
• Contact or meet with all self-pay patients and screen all accounts for medical assistance eligibility.
• Maintain knowledge of medical assistance and Virtual Gateway screening and application processes.
• Counsel the patient on documentation/process required to access state/federal programs.
• Assist patients approved for Basic MassHealth coverage with enrollment in Primary Care Clinician program.
• Act as a liaison between patient and MassHealth to assist patient with any MassHealth problem or concern.
• Maintains a role as a resource person for Patient Registration, Scheduling, physicians’ office, and other hospital depts. regarding insurance requirements.
• Keep current in knowledge of insurance plan design.
• Performs basic registration functions. Supports Patient Registration services as needed.
• Make recommendations to improve Patient Access Service systems and processes.
• Maintain working knowledge of payor website applications used to conduct eligibility.
• Create a friendly caring environment by being considerate to coworkers and outside consultants/outreach worker.
• Be compassionate to patients’ concerns regarding their insurance coverage and questions they might have.
• Respond to questions in a timely manner.
• Adheres to Medical Center dress code promoting a good image of themselves, their department, and the Medical Center
• Work closely with the Community Health Advocates

Required Knowledge & Skills:

• Reception/office or other healthcare experience required. Medical setting and medical terminology preferred. Previous computer entry/word processing experience required. Strong communication and interpersonal skills required.
• Knowledge of price transparency/estimates.
• Excellent organizational, interpersonal and communication skills a must. Must be detail oriented and computer literate. Knowledge of Medical Terminology and Coding (CPT-4, DRG and ICD-9-CM)

Education:

High school diploma or equivalent

Experience:

3+ years of experience with health care insurance benefits, eligibility preferred.

Certification/Licensure:

Certification Application Counselor (CAC) required within 60 days of hire.

Software/Hardware:

Previous computer entry/word processing experience required. Epic knowledge preferred. Strong communication and interpersonal skills required.

Compensation Range:

$17.84- $26.51

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, and licensure/certifications directly related to position requirements. In addition, BMCHS offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), contract increases, Flexible Spending Accounts, 403(b) savings matches, earned time cash out, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.

Equal Opportunity Employer/Disabled/Veterans

According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not ask or require downloads of any applications, or “apps” job offers are not extended over text messages or social media platforms. We do not ask individuals to purchase equipment for or prior to employment.