Health Coverage Counselor & Enrollment Specialist

UMass Memorial Health; Marlborough (MA); On-site; USD 39,000 - 62,000; Full time

Benefits offered by this job

Signing bonus potential

Union: SHARE Marlborough

Job summary

UMass Memorial Health is seeking a Financial Counselor (CAC required) to assess patients' health coverage options, determine eligibility for MassHealth, Health Connector, and related programs, and guide families through the enrollment process.

Reporting to Financial Counseling leadership, you will staff the call center, coordinate with clinics, and ensure accurate documentation, while upholding the organization's standards of respect and patient-centered care.

Qualifications

• High School Graduate; CAC certification required within 45 days of hire.
• CAC certification within 45 days of hire is required.
• Preferred: Associate or bachelor’s degree in Business, Social Services or related field.

Responsibilities

• Interviews and screens applicants to determine eligibility for health coverage.
• Determines qualification for affordable health insurance coverage, including premium tax credits and other programs.
• Interacts with patients and external partners professionally per UMMHC mission.
• Facilitates enrollment through Health Connector or other programs with accurate paperwork.
• Follows up with patients to obtain necessary confidential information for eligibility.
• Acts as liaison for MassHealth and Health Connector to resolve eligibility issues.
• Explains eligibility rules, coverage types, enrollment periods, and plan options.
• Manages the financial counseling call center as a resource for patients and staff.
• Provides price estimates to patients per price transparency regulations.
• Works with EPIC work queues to identify uninsured/underinsured patients for assistance programs.
• Collaborates with clinical areas and community partners to ensure access to care.
• Discusses financial obligations before elective procedures and communicates with providers.
• Updates accounts to reflect current status and eligibility dates.

Skills

Customer service

Data entry

Effective communication

Healthcare billing

English proficiency

Education

High School Graduate

CAC certification (within 45 days)

Associate or Bachelor’s degree (preferred)

Tools

EPIC software

Job description

UMass Memorial Health is seeking a Financial Counselor (CAC required) to assess patients' health coverage options, determine eligibility for MassHealth, Health Connector, and related programs, and guide families through the enrollment process.

Reporting to Financial Counseling leadership, you will staff the call center, coordinate with clinics, and ensure accurate documentation, while upholding the organization's standards of respect and patient-centered care.