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Exemption Status:

Non-Exempt

Hiring Range:

$17.36 - $31.26

Please note that the final offer may vary within this range based on a candidate’s experience, skills, qualifications, and internal equity considerations.

Schedule Details:

Monday through Friday

Scheduled Hours:

8:00am - 4:30pm

Shift:

1 - Day Shift, 8 Hours (United States of America)

Hours:

40

Cost Center:

25080 - 5428 Financial Counseling

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 Lead Financial Counselor (Certified Application Counselor) provides functional oversight to an assigned group of Financial Counselors for the process of providing health care coverage needs assessment with patients, community applicants, and family members.

I. Major Responsibilities:
1. Responsible for distributing and monitoring the flow of work for an assigned group of Financial Counselors.

2. Prioritizes work in high volume, fast paced, team-oriented environment.  
3. 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. 
4. 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.
5. Interacts with patients, the community, and outside agencies in a professional manner in keeping with the Mission and Vision of UMMHC.
6. 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.
7. 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.
8. 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.
9. 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.
10. 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.
11. Provides and documents price estimates request to patients in accordance with federal price transparency regulations. 
12. 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.
13. 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