PAS Financial Counselor

UMass Memorial Health; Leominster (MA); On-site; USD 22,785 - 40,997; Part time

Benefits offered by this job

Signing bonus may be available

Job summary

UMass Memorial Health in Leominster, MA is seeking a Certified Application Counselor to assess health coverage needs and determine MassHealth/CHIP/Health Connector eligibility. The role supports enrollment, assists patients and staff, and guides families on financial assistance programs.

Responsibilities include interviewing applicants, applying government guidelines, coordinating with clinics, and updating patient records.

Qualifications

• High School Graduate with CAC certification within 45 days of hire and mandatory training.
• CAC certification must be maintained with annual recertification where required.
• Preferred: associate or bachelor's degree in Business, Social Services or related field.

Responsibilities

• Interview and assess applicants and family members for health coverage eligibility.
• Determine qualification for affordable health insurance and assistance programs.
• Interact with patients, community, and external agencies professionally.
• Facilitate enrollment through Health Connector or other program applications.
• Follow up with patients to gather required information for eligibility.
• Serve as liaison with MassHealth, Health Connector and Health Safety Net.
• Explain coverage options and enrollment periods to patients and families.
• Cover the Financial Counseling call center for insurance questions.
• Provide price estimate requests per federal price transparency rules.
• Work with EPIC queues to screen uninsured/underinsured patients.
• Collaborate with clinical and community partners to ensure access and discharge planning.
• Discuss financial obligations with patients prior to surgeries/admissions.
• Update accounts with current status and eligible financial classifications.

Skills

Healthcare experience

Accounts receivable

Financial counseling

Medical billing

Data entry

Organization skills

Communication skills

Customer service

Independent work

Transportation

Bilingual (optional)

English literacy

Education

High School Graduate

CAC certification within 45 days

Associate or bachelor's degree in Business / Social Services

Job description

Exemption Status: Non-Exempt

Compensation Range: $16.54 - $29.76 per hour. Final offer may vary within this range based on experience, skills, qualifications, and internal equity considerations.

Schedule: Monday through Friday, 8:30am - 1:30pm (Day Shift). 8 hours per day, 24 hours per week.

Cost Center: 24040 - 5677 Patient Financial Counseling.

Signing Bonus: May be available; eligibility confirmed during interview process.

Job Overview

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 assessing patients, community applicants, and family members' health care coverage needs. The role determines eligibility for MassHealth, Qualified Health Plans, Children's Health Insurance, Health Safety net and other coverage, provides guidance and assistance to patients, internal UMass staff, physician offices and third-party vendors regarding financial assistance programs.

Major Responsibilities

1. Interview, screen, and assess applicants and family members at various on-campus locations using income and household composition and other criteria in accordance with CMS and governmental eligibility guidelines.
2. Determine qualification for affordable health insurance coverage, including application of advance premium tax credits (APTC), premium assistance programs, Medicare Savings Plans and other eligible programs.
3. Interact with patients, the community, and outside agencies in a professional manner consistent with UMMHC Mission and Vision.
4. Facilitate enrollment through the online Health Connector Health Insurance Exchange (HIX) or other program application by accurate and timely submission of necessary paperwork per state and federal regulations and policies.
5. Follow up with patients in person or by telephone to obtain appropriate confidential financial and medical information on incomplete applications to establish eligibility for various financial assistance programs.
6. Act as liaison for patients with MassHealth, Health Connector and Health Safety Net to assist in resolving eligibility discrepancies, updating application status, and addressing other issues arising in the determination process.
7. Facilitate patient understanding of health access options including eligibility rules, coverage types, enrollment periods, products and plans available through MassHealth, Health Connector, Medicaid Managed Care, and Health Safety Net programs.
8. Provide coverage of the Financial Counseling call center to act as a resource for patients and families, community members, clinical departments and other Revenue Cycle departments with insurance coverage issues and questions.
9. Provide and document price estimates requests to patients in accordance with federal price transparency regulations.
10. Work within EPIC work queues to identify and reach out to uninsured/underinsured patients/families for screening and assistance program upgrades.
11. Collaborate with clinical areas, interpreters, social workers, case managers, social security outreach workers, drug assistance coordinators, enhanced benefit coordinators, care mobile, physician/provider offices and community health centers to ensure access to care and timely discharge planning.
12. Discuss financial obligations with patients prior to elective surgical days or admissions, communicating all information to provider offices and other Revenue Cycle departments.
13. Update all accounts to reflect current status with appropriate financial class, eligibility dates, and other patient financial and demographic information.

Standard Staffing Level Responsibilities

1. Comply with established departmental policies, procedures and objectives.
2. Attend variety of meetings, conferences, seminars as required or directed.
3. Demonstrate use of Quality Improvement in daily operations.
4. Comply with all health and safety regulations and requirements.
5. Respect diverse views and approaches, demonstrate Standards of Respect, and contribute to creating and maintaining an environment of professionalism, tolerance, civility and acceptance toward all employees, patients and visitors.
6. Maintain regular, reliable, and predictable attendance.
7. Perform other similar and related duties as required or directed.

Position Qualifications

License / Certification / Education:

• Required:
  • High School Graduate.
  • Certified Application Counselor (CAC) certification within 45 days of hire, and annual recertification as required.
  • Complete all mandatory ongoing training via Massachusetts online Learning Management System.
• Preferred:
  • Associate or bachelor's degree in Business, Social Services or related field.

Experience / Skills:

• Required:
  • Previous experience in healthcare, accounts receivable, financial counseling, medical billing, or a related field.
  • Proficient data‑entry and strong organization skills with attention to detail.
  • Effective communication and customer service skills, both verbal and written.
  • Ability to use specialized applications software and computer systems for patient registration and scheduling.
  • Ability to work independently with strong problem‑resolution skills.
  • Provide own transportation.
  • Ability to prioritize and work in high volume, fast‑paced, team‑oriented environment.
  • Ability to take directions and work independently.
  • English speaking, reading and writing skills.
• Preferred:
  • Ability to speak, read, and write another language (bilingual).

Unless certification, licensure or registration is required, an equivalent combination of education and experience that provides proficiency in the responsibilities listed may be substituted.

Physical Demands and Environmental Conditions

Work is considered light with frequent walking throughout the day. Position requires working indoors in a normal office and/or patient care environment.

The Organization reserves the right to modify position duties at any time.

Equal Opportunity Hiring

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status or any other status protected by law. UMass Memorial Health is an equal‑opportunity and affirmative action employer and encourages applications from individuals with varied experiences, perspectives and backgrounds.