Financial Counselor

Financial Counselor

Financial Counselor provides application assistance to applicants and beneficiaries of Qualified Health Plans and insurance affordability programs including MassHealth and health insurance programs offered through the Massachusetts Health Connector. The Certified Application Counselor interviews, assesses and screens patients for eligibility for such plans and assists in the enrollment and application process. The Certified Application Counselor (CAC) is responsible for tracking and processing accurate, complete and timely applications with regards to Codman Square Health Center billing practices and procedures and is consistent with the Certified Application Counselor Policy Requirements.

The Financial Counselor will also provide payment solutions for self-pay patients that do not meet the eligibility requirements for affordability programs, including but not limited to payment plans and Sliding Fee Discount Plan. The Financial Counselor is expected to deliver superior customer service to both internal and external customers at all times.

Primary Responsibilities:

• Collects and verifies patient demographics, insurance eligibility, and financial information to help patients navigate enrollment with an insurance plan, as well as accurately document all data elements in Health Center electronic medical record and applicable computer systems.
• Follows up with patients and obtains all documentation required for application processing and accurately enters information into health center and external systems as appropriate.
• Screens all self-pay patients; identifying payment plan or discount plan options based on income level and family size.
• Collects initial payments for sliding discount patients, while also reviewing patient accounts for prior balances.
• Assists patients in establishing secured installments plans in accordance with Codman Square Health Center Financial Assistance Policy.
• Monitors, manages and actively follows up on active self-pay balances to optimize copayment and self-pay collections for the health center.
• Reviews work queues and other aged trial balances to collect on past due balances as well as current patient statement balances to increase payment collection rates for the Health Center.
• Fields patient billing inquiries and refers to appropriate Revenue Cycle staff for resolution.
• Responsible for remaining current and up to date on all of department Policy and Procedures pertaining to reimbursement and customer service.
• Meets performance standards established by Revenue leadership, including but not limited to: quality, collections, customer service, screening/solution rates, and productivity.
• Works effectively with Patient Access peers and other Health Center departments.
• Delivers exemplary customer service for patients in accordance with Health Center expectations / guidelines.
• Demonstrates respect and regard for the dignity of all patients, families, visitors, and fellow employees to ensure a professional, responsible, and courteous environment.
• Communicates effectively with internal and external customers with respect to differences in cultures, values, beliefs and ages, utilizing interpreters when needed.
• Performs all other duties as assigned.

Other duties and/or other locations as assigned

Qualifications and Skills:

• Associate's degree preferred. High School Diploma or equivalent required.
• CAC Certification Required.
• 2-3 years' experience in health center registration/billing office/clinical department with a current working knowledge of registration, insurance, and billing requirements.
• Maintains working knowledge of private, public and third-party payer insurance and related regulations.
• Competent utilizing Microsoft office, e.g., Excel, Access, PowerPoint, and Word.
• Familiarity and experience with Epic and Ochin PM Systems.
• Analytical, e.g. competent math skills.
• Excellent customer service/communication skills required.
• Ability to work with a high degree of confidentiality.
• Aptitude / familiarity with the tools, systems, and technologies to enable insurance verification and facilitate insurance solutions.
• Knowledge of health insurance and reimbursement/billing required.
• Ability to problem solve and follow through under ambiguous circumstances
• Bi-lingual – Haitian Creole or Spanish preferred.

Physical Requirements:

• Must be able to stand or sit for prolonged periods (50% of the time) ·
• Must be able to lift 10-25 pounds and load onto shelves.
• Visual acuity sufficient for frequent reading and computer use.