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Summary:

Schedule: Fulltime; Monday-Friday; Day Shift

Under the direction of the Financial Counselor Supervisor and Manager, a Financial Counselor will provide services to uninsured and underinsured patients in assigned inpatient and outpatient settings. These services include walking patients through state-wide insurance and grant program options, certified assistance in application process, and insurance benefit and self-pay balanced education.

Job Responsibilities:

**1)** Secures sponsorship for uninsured and underinsured patients by screening them for eligibility for a variety of grant and/or government-sponsored programs, identifying and counseling Medicare patients without secondary insurance, assisting with applications for supplemental coverage, and ensuring all billing information has been obtained for liability cases and newborn coverage.

**2)** Assists patients in completing MassHealth, DDU, and BHS Financial Assistance applications and helps approved patients in selecting a plan and denied patients in redetermination efforts.Tracks the status of initiated applications to facilitate and expedite the approval process

**3)** Corrects/updates patient and guarantor demographic, financial, and insurance information in appropriate systems. Ensures that all data collected fulfills requirements for claim submission to third parties. Thoroughly documents significant account activity appropriately.

**4)** Maintains knowledge of current resources available to the uninsured and underinsured, making appropriate referrals as necessary.

**5)** Collaborates with case managers, social workers, and nursing units on various eligibility requirements and patient benefits to obtain the most comprehensive coverage and sponsorship possible.

**6)** Maintains knowledge of payer guidelines pertaining to benefit, eligibility, and authorization information by use of web portals and carrier communications.

**7)** Correct/update patient and guarantor demographic, financial, and insurance information in appropriate systems. Ensure that all data collected fulfills requirements for claim submission to third parties. Document significant account activity appropriately.

**8)** Meets all productivity standards for the position.

**9)** Maintains an account accuracy average rate of >/= 97%.

**10)** Demonstrates understanding and skilled use of necessary computer programs.

**11)** Cross-trained to grade 42 registration responsibilities. BMLH ONLY

**12)** Performs mentoring responsibilities during the new staff introductory period.

**13)** Demonstrates knowledge of hospital billing functions and applications.

**14)** Attends state and regional meetings regarding MassHealth guidelines and training. Shares knowledge with fellow staff and leadership professionally and in an effort to close any education gaps.

**15)** Demonstrates organizational awareness in order to take initiative to find solutions to problems. Initiates improvements for benefit of team. Content expert for assigned activities and resource to team. Provides feedback and coaching to fellow employees when the opportunity presents.

**16)** Acts as a role model for staff by exhibiting positivity, confidence, and an overall professional attitude.

**17)** Exceeds both departmental QA and Productivity standards. Performs QA on all non-level IV team members.

**18)** Assists leadership with the creation and maintenance of departmental Policies and Procedures.

**19)** BFMC ONLY: review and respond to patient billing questions, receive and correctly apply payments to patient accounts in HP24, complete daily cashier functions, and prepare deposits as needed and/or as assigned

**20)** BWH and BNH ONLY: Cross-trained to grade 42 registration responsibilities.

**21)** BWH and BNH ONLY: Registers and/or pre-registers patients both in person and via telephone.

Required Work Experience:

Mastery in Financial Counseling Level III activities

Preferred Work Experience:

Healthcare Accounts Receivable or equivalent Bilingual (English/Spanish)

Skills and Competencies:

None Listed

You Belong At Baystate

At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.

DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.

Education:

GED or HiSET (Required)

Certifications:

Equal Employment Opportunity Employer

Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.