Patient Business Representative

Patient Business Representative

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.

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.

Essential Functions:

• Responsible for screening patients for MassHealth, CarePlus, Connector Care, Health Safety Net, assisting in the application process when appropriate.
• Submits applications all Massachusetts applications for health coverage via the Health Connector.
• Verify patients' insurance coverage and eligibility to ensure accurate billing and claims processing.
• Collect and record patient demographic and insurance information accurately during the registration process.
• 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.
• 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.
• Assists patients in the redetermination process for MassHealth, Connector Care and or Health Safety Net.
• Offer financial counseling and assistance programs to patients who may require financial support for medical services.
• Adhere to relevant billing regulations, insurance guidelines, and hospital billing policies to ensure compliance with healthcare laws and ethical standards.
• Acts as a liaison between the patients, hospital billing department and BWPO practices/billing agencies in addressing any billing related inquires and issues.
• Accepts and/or arranges payment for deductibles and outstanding balances.

Qualifications:

Education:

High School Diploma/GED required

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.

Additional Job Details (if applicable):

Remote Type: Hybrid

Work Location: 45 Francis Street

Scheduled Weekly Hours: 40

Employee Type: Regular

Work Shift: Day (United States of America)

Pay Range: $19.81 - $28.30/Hourly

EEO Statement:

0100 Mass General Brigham Incorporated is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran's Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources.