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Exemption Status:

Non-Exempt

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:

24040 - 5677 Patient Financial Counseling

Union:

SEIU - Service & Maintenance HealthAlliance Burbank

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 Financial Counselor (Certified Application Counselor) provides a key role
in providing a health care coverage needs assessment with patients, community applicants, and
family members. Determines eligibility for MassHealth, Qualified Health Plans, Children’s Health
Insurance, Health Safety net and any other coverage that they may qualify. Provides guidance and
assistance to patients, various internal UMass staff, physician offices and third-party vendors
regarding financial assistance programs.

Major Responsibilities:
1. 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. 
2. 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. 
3. Interacts with patients, the community, and outside agencies in a professional manner in 
keeping with the Mission and Vision of UMMHC. 
4. 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. 
5. 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.
6. 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. 
7. 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.
8. 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.
9. Provides and documents price estimates request to patients in accordance with federal price 
transparency regulations. 
10. 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.
11. 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. 
12. Discusses financial oblig