Boston Medical Center (BMC) · 3 months ago
Outpatient Financial Counselor Quincy - 24 Hours M-W 8:30AM-5P U
United States
Part-time
Remote
Mid Level
3+ years expBoston Medical Center (BMC) is a healthcare institution dedicated to providing quality care to vulnerable populations. The Quincy Outpatient Financial Counselor plays a crucial role in helping patients access healthcare coverage and financial assistance, while also safeguarding BMC's revenue. This position involves engaging with patients to determine eligibility for various insurance programs and assisting them in the enrollment process.
Health CareHospitalMedicalNon Profit
Responsibilities
Demonstrates respectful personal conduct and utilizes AIDET when engaging patients and visitors
Completes MassHealth’s curriculum for Certified Application Counselor and renews certification annually
Provides information about the full range of medical and dental insurance programs available through the Health Insurance Exchange (HIX)
Interviews patients, in a language and manner best understood, to determine eligibility and communicate enrollment options and plan benefits for which patients qualify. Answers questions about Qualified Health Plans (QHP) and Qualified Dental Plans (QDP). Explains subsidized Qualified Health Plans available through premium tax credits or informs patients of expected out-of-pocket expenses, co-pays, and deductibles when applicable
Utilizes protected software programs to determine patient eligibility for MassHealth, Health Safety Net, ConnectorCare, and other insurance carriers and assists with enrollment process
Initiates communication with patients, by phone, mail, or email, , to initiate new applications or plan renewals for health insurance coverage. Informs patients of important deadlines, effective dates for coverage, and required documentation to determine eligibility
Scans MassHealth applications and supporting verification documents into HIX and patients’ Epic record
Documents in Epic the status of all applications initiated by adding a financial tracker and recording actions taken and follow-up efforts required to complete and submit for processing
As requested, assists patients with enrolling in an ACO or changing selection of ACO, to ensure continued access to covered services
Provides voter registration information and registration assistance as needed; completes appropriate patient declination form for applicants as requested
Validates and updates active insurance coverage in the hospital registration and billing system on accounts with covered dates of service
Assists patients with billing questions or concerns. For patients deemed ineligible for financial assistance programs, provides information regarding self-pay discount and payment plan options
Collects and posts payments for balances related to self-pay, Ad-Hoc, and Flat Fee contracts in accordance with BMC policy and procedure for collection practices
Interacts with numerous departments to resolve insurance and billing questions e.g., Customer Service, Pharmacy, Social Service, Case Management, Patient Accounts ,Clinic Staff, Unit Nursing staff, professional billing etc
Provides pricing estimates for elective services, as requested, if patient is uninsured or if services are uncovered by payor
Understands and adheres to rules established by the BMC Credit and Collection Policy
Assists patients with confidential applications for protected services, adding account notes to notify others of the patient’s protected status
Assists patients with medical hardship and confidential applications, obtaining and submitting verification documents and applicable medical bills required to apply and make a determination of eligibility
Responds to telephone calls in a courteous manner. Responds promptly to all inquiries from staff, patients, and general public. As needed, refers callers to other departments or resources deemed appropriate for resolution
Presents and interacts respectfully and professionally with BMC patients, visitors, and other team members; works cooperatively and respectfully with other departments and disciplines across the organization
Maintains daily written reports of work activity to document patient enrollments and outcomes; patient complaints and resolutions; patient declinations, etc
Demonstrates superior customer service standards
Participates in regular staff meetings and scheduled trainings to maintain required core competencies
Serves as a resource and subject matter expert regarding financial assistance programs. Provides education and advisement on health insurance options and enrollment requirements for other hospital departments, community health centers, community leaders and other personnel as needed
Under the direction of PFC Manager, assists with the orientation, including shadowing of new staff as assigned
Validates and/or updates demographic and income information in HIX portal for “known” patients with prior history of program eligibility
Validates patients’ active insurance coverage and updates current plans in Epic
Collects and posts payments on accounts with outstanding balances. Maintains and closes Epic Cash Drawer and documents transactions in patients’ financial trackers
Schedules tasks for Financial Counseling Enrollment Coordinators, (FCECs) to conduct patient follow-up on pending applications to ensure that required documents are obtained and applications are completed and submitted timely to secure retroactive coverage
Protects patient and family confidentiality
Performs other duties and tasks as assigned
Qualification
Required
High School diploma with 3-5 years of strong customer service experience in healthcare or human services setting required
Must complete MassHealth's curriculum for Certified Application Counselor, (CAC) and maintain certification renewal annually
Individual must complete training and obtain CAC certification within 45 days of hire date
Work experience to include 2-3 years of strong customer service experience, preferably in a healthcare or human services setting
Demonstrates professionalism, maturity, and confidence needed to work effectively in a diverse, multi-cultural, and decentralized environment
Displays strong, consistent communication skills, (oral and written), interpersonal skill, and record keeping skills
Demonstrates knowledge and understanding of eligibility criteria and application process for programs offered through MassHealth, Health Safety Net, ConnectorCare, and BMC's Charity Care Program
Displays strong organizational skills with ability to manage multiple tasks simultaneously; prioritize work assignments appropriately; and complete follow up task timely
Demonstrates strong work ethic and ability to meet performance goals for productivity and outcomes with minimal direct supervision
Demonstrates critical thinking and sound judgment in addressing and resolving barriers, issues, or concerns identified
Requires strong technical computer skills and proficiency in utilizing Epic and external database systems to research cases and successfully assist patients in securing active coverage
Displays exceptional customer skills and the ability to engage patients, family members, and team members respectfully, with empathy and cultural sensitivity
Preferred
Bachelor's degree strongly preferred
Bilingual persons and persons with hospital and/or healthcare experience strongly preferred
Company
Boston Medical Center (BMC)
Boston Medical Center (BMC) is a 511-bed, equity-led academic medical center and a proud member of the Boston Medical Center Health System.
5001-10000 employees
H1B Sponsorship
Boston Medical Center (BMC) has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (53)
2024 (51)
2023 (51)
2022 (38)
2021 (26)
2020 (32)
Funding
Current Stage
Late StageTotal Funding
$342.49MKey Investors
AmeriCorps Public AlliesNational Institute on Drug Abuse (NIDA)The Boston Foundation
2024-07-09Grant· $0.06M
2023-02-23Debt Financing· $232M
2019-04-23Grant· $89M
Leadership Team
David Beck
Senior Vice President & Chief Legal Counsel
Recent News
2025-11-11
2025-11-10
Company data provided by crunchbase