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Certified Application Counselor

4 months ago

Boston, United States Boston Medical Center Full time

***:
**Position**:Certified Application Counselor - Quincy**

**Department: Financial Counseling**

**Schedule: Full Time**

**ESSENTIAL RESPONSIBILITIES / DUTIES**:

- 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.
- 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.
- 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 declination, etc.
- Demonstrates superior customer service standards.
- Participates in regular staff meetings and scheduled training to maintain required core competencies.
- 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.
- Protects patient and family confidentiality.

**JOB REQUIREMENTS**

**EDUCATION**:
High School diploma required, College degree preferred.

**CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED**:
Individual must receive training and be certified as a Certified Application Counselor within 45 days of employment.

**EXPERIENCE**:
Minimum of two years of Customer Service experience or equivalent combination of education and experience.

**KNOWLEDGE AND SKILLS**:

- Must be extremely organized, able to appropriately prioritize, to make independent decisions, and must have strong problem resolution skills and the ability to manage a heavy caseload of patients.
- Must demonstrate computer competency with use of keyboard and mouse and must demonstrate excellent customer service skills.

Equal Opportunity Employer/Disabled/Veterans