Patient Business Representative

Site: Mass General Brigham Incorporated

 

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

 

Job Summary

Summary<br>The Patient Business Rep (PBR) functions as a financial counselor and registrar and is responsible for the in-depth evaluation of financial history for both uninsured and underinsured patients for the purpose of determining eligibility for government and pharmacy financial assistance programs. The PBR will serve as the primary practice contact when patients require assistance with various billing/financial related issues.<br><br>Does this position require Patient Care?<br>No<br><br>Essential Functions<br>-Responsible for screening patients for MassHealth, CarePlus, Connector Care, Health Safety Net, assisting in the application process when appropriate. <br>
-Submits applications all Massachusetts applications for health coverage via the Health Connector. <br>
-Verify patients' insurance coverage and eligibility to ensure accurate billing and claims processing. <br>
-Collect and record patient demographic and insurance information accurately during the registration process. <br>
-Assists patients in applying for and/or understanding all other financial assistance programs or low cost insurance plans such as the Insurance Partnership, Medical Security Plan, and Health Connector Plans. <br>
-Acts as patient representative in any cases submitted via the Health Connector, paper or over the phone, assisting the patient in deciphering notices received from EOHHS. <br>
-Assists patients in the redetermination process for MassHealth, Connector Care and or Health Safety Net. <br>
-Offer financial counseling and assistance programs to patients who may require financial support for medical services. <br>
-Adhere to relevant billing regulations, insurance guidelines, and hospital billing policies to ensure compliance with healthcare laws and ethical standards. <br>
-Acts as a liaison between the patients, hospital billing department and BWPO practices/billing agencies in addressing any billing related inquires and issues. <br>
-Accepts and/or arranges payment for deductibles and outstanding balances. <br>

 

Education

High School Diploma/GED required
Bachelor's Degree Health Administration /bachelor's degree Related Field of Study preferred 

Can this role accept experience in lieu of a degree?
Yes

Licenses and Credentials

Experience
Registration/Hospital Patient Billing Experience 1-2 years preferred

Knowledge, Skills and Abilities
- Knowledge of healthcare billing and insurance terminology, including CPT codes, ICD-10 codes, and insurance claim processing.
- Excellent communication and interpersonal skills to interact with patients, families, and hospital staff in a professional and empathetic manner.
- Strong attention to detail and accuracy in handling financial transactions and billing records.
- Ability to handle sensitive and confidential patient financial information with discretion.
- Problem-solving skills to address billing inquiries and resolve payment-related issues.

 

Physical Requirements

Standing Occasionally (3-33%)

Walking Occasionally (3-33%)

Sitting Constantly (67-100%)

Lifting Occasionally (3-33%) 20lbs - 35lbs

Carrying Occasionally (3-33%) 20lbs - 35lbs

Pushing Rarely (Less than 2%)

Pulling Rarely (Less than 2%)

Climbing Rarely (Less than 2%)

Balancing Occasionally (3-33%)

Stooping Occasionally (3-33%)

Kneeling Rarely (Less than 2%)

Crouching Rarely (Less than 2%)

Crawling Rarely (Less than 2%)

Reaching Occasionally (3-33%)

Gross Manipulation (Handling) Constantly (67-100%)

Fine Manipulation (Fingering) Frequently (34-66%)

Feeling Constantly (67-100%)

Foot Use Rarely (Less than 2%)

Vision - Far Constantly (67-100%)

Vision - Near Const