Senior Patient Coverage Navigator

Boston Medical Center; Boston (MA); Presencial; USD 40.000 - 57.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Medical benefits

Flexible Spending Accounts

403(b) matching

Paid time off

Retirement plan

Descripción de la vacante

Boston Medical Center is seeking a Senior Financial Counselor to ensure uninsured and underinsured patients obtain coverage and access to care. This role supports registration accuracy and eligibility determinations across inpatient and outpatient settings, with focus on SHINE and CAC certifications.

You will work under supervision to assist patients with applications, appeals, and payment options while coordinating with cross-functional teams to meet regulatory and billing standards.

Formación

• Assist uninsured/underinsured patients in obtaining coverage through MassHealth, Medicaid, Health Safety Net, and related programs.

Responsabilidades

• Assist uninsured and underinsured patients in obtaining healthcare coverage through MassHealth, Medicaid, Health Safety Net, Connector Care, Medicare programs, and BMC’s Charity Care Program.
• Facilitate applications, appeals, and eligibility notifications, and provide guidance on cost-saving options.
• Educate patients on Medicare Part D, Medigap, Senior Care Options (SCO), and Medicare Savings Programs, and provide referrals to external resources such as Boston ElderINFO.
• Serve as a resource to patients and staff regarding insurance eligibility, SHINE program options, and payor enrollment/disenrollment.
• Maintain Certified Application Counselor and SHINE certifications, including completing required curriculum, annual recertifications, and monthly activity requirements.
• Participate in departmental meetings, trainings, and SHINE leadership meetings to support continuous improvement and collaboration.
• Conduct full registration and verify patient insurance using established methods.
• Ensure accuracy of patient demographic, insurance, and admission data in BMC’s information system.
• Contact patients by phone, email, mail, or with interpreter services to obtain applications, consent forms, and verification documents.
• Facilitate applications, appeals, and written notifications of eligibility determinations.
• Document accurate information on patient accounts, update coverage and billing indicators, and track pending applications until final disposition.
• Use work queues, protected software, and reporting tools to identify self-pay accounts and monitor pending applications.
• Track applications to completion, close financial trackers, and ensure compliance with regulatory and hospital standards.
• Identify opportunities to obtain retroactive coverage when appropriate and respond to billing inquiries by advising patients on payment plans, discounts, and charity care options.

Conocimientos

Financial counseling

Patient eligibility

SHINE certification

MassHealth/Medicaid knowledge

Data accuracy

Communication

Registration knowledge

Educación

High school Diploma/GED

Bachelor’s Degree preferred

Herramientas

Billing system

Descripción del empleo

Boston Medical Center is seeking a Senior Financial Counselor to ensure uninsured and underinsured patients obtain coverage and access to care. This role supports registration accuracy and eligibility determinations across inpatient and outpatient settings, with focus on SHINE and CAC certifications.

You will work under supervision to assist patients with applications, appeals, and payment options while coordinating with cross-functional teams to meet regulatory and billing standards.