Patient Financial Services Counselor (On-Site)

Beth Israel Lahey Health, Inc.; Peabody (MA); On-site; USD 30,000 - 40,000; Full time

Benefits offered by this job

Comprehensive benefits

Job summary

Beth Israel Lahey Health seeks a Patient Financial Services Counselor to guide patients through billing, insurance options, and coverage gaps. Under supervision, you will assist with statements, payment plans, and pricing estimates while upholding CMS price transparency rules.

You'll collaborate with Hospital and Professional Billing, Patient Access, and Customer Service to resolve financial issues and ensure a positive patient experience across the health system.

Qualifications

• High School Diploma required.
• CAC Certification preferred, CPC Certification is a plus.
• 2-3 years experience in Financial Counseling, Social Work, Case Work, Patient Access or Billing field preferred and a general understanding of hospital and professional billing procedures.
• EPIC system experience preferred.

Responsibilities

• Assist patients over the phone or in person to address financial matters or concerns; discuss and document issues from notices, statements or billing/insurance issues.
• Explain Explanation of Benefits (EOB), insurance policies and covered services to patients.
• Educate and enroll qualified patients in payment plans and assist with Financial Assistance (Charity).
• Coordinate with departments and providers to resolve coverage and billing issues; provide timely estimates for services in compliance with CMS price transparency rules.

Skills

Customer service

Communication

Interpersonal skills

Multitask

Education

High School Diploma

Tools

EPIC system

MS Office

Job description

When you join the growing BILH team, you're not just taking a job, you’re making a difference in people’s lives. Under the direct supervision of the Supervisor of Financial Counseling and leadership of the Manager of Financial Counseling, the Patient Financial Services Counselor acts as a liaison for patients to the health system; providing guidance and support for all financial components of healthcare; specifically focusing on billing concerns, understanding insurance options and benefits, gaps in coverage, and payment options. Additionally, the Patient Financial Services Counselor provides assistance with patient statements, payment plans, pricing estimates, Financial Assistance, Federal/State benefits, and the managed care process. This position supports Patient Access and both Hospital and Professional Billing areas and works in conjunction with Customer Service.

Job Description: Essential Duties & Responsibilities including but not limited to:

Maintains annual Certified Application Counselor certification for the state of Massachusetts. Assists over the phone or in-person to address financial matters or concerns; discusses and documents any issues resulting from collection notices, statements, and/or other billing and insurance issues. Responsible for helping patients understand their Explanation of Benefits (EOB) including insurance policies and covered services. Works with departments and providers throughout the organization to ensure the resolution of patient financial concerns; this includes elective, plastic, and/or low coverage or non-covered medically urgent procedures. Helps coordinate services with outside stakeholders to provide necessary coverage for patients who require an enhanced coordination of benefits due to disabilities. Follows established protocols ensuring appropriate financial counseling actions have been taken and communicates back to the department prior to scheduling procedures that will not be covered by insurance. This includes elective, plastic, and/or low coverage or non-covered medically urgent procedures. Assists with providing timely estimates for services to patients (either orally or in writing) in compliance with CMS price transparency regulations. Collects payments for self-pay patients: pre-payments and outstanding balances including copayment and deductibles, and out of pocket expenses in accordance with PFS policy and procedures. Follows guidelines set forth by leadership to educate and enroll qualified patients in payment plans for outstanding or anticipated balances. Screens and approves patients for Financial Assistance (Charity) by following Financial Assistance Policy guidelines. Visits patients who are inpatient or in the outpatient clinics, when appropriate, to discuss coverage applications and payment options. Supports patients with MassHealth/Medicaid Open Enrollment; providing education and processing necessary applications. Addresses Managed Care concerns with patients who require assistance. Works directly with Customer Service for resolution of financial issues including account adjustments, statement generation, or billing errors. Works on projects as assigned. Adheres to all corporate and governmental compliance issues as directed. Compliance with all Cash and Collection Policies and Procedures. Adheres to our Customer Service standards to provide exceptional patient service.

Minimum Qualifications

Education: High School Diploma required Licensure, Certification & Registration: CAC Certification preferred. CPC Certification is a plus. Experience: 2-3 years experience in Financial Counseling, Social Work, Case Work, Patient Access or Billing field preferred and a general understanding of hospital and professional billing procedures. EPIC system experience preferred. Skills, Knowledge & Abilities: Excellent customer service skills. Excellent written and oral communication and interpersonal skills required. Must exhibit tact, diplomacy, and discretion at all times. Must be able to multi-task and work in a fast-paced, detail-oriented environment. Working knowledge of MS Office suite and database systems with the ability to learn new systems as they become available. In the absence of any of these skills, must demonstrate the ability to be thoroughly trained to meet organizational standards.

Pay Range

Pay Range: $21.53 - $28.98 The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law.

Benefits

• We make it a priority to offer comprehensive compensation and benefits and help you achieve a healthy and balanced life.

Equal Opportunity Employer/Veterans/Disabled

Equal Opportunity Employer/Veterans/Disabled At Beth Israel Lahey Health, we are driving the change in health care that Massachusetts wants and needs.

Additional Information

As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment. More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger. Our culture promotes continuous learning, growth, innovation and a sense of belonging. While you're busy caring for and supporting our patients, we take care of you.