Under the general directions of the Administrative Manager, Patient Financial Services, the Patient Financial Aid Representative will work with our patients applying for Government/ State Programs and instructing patients on what is needed to complete an application or redetermination or review. Duties and responsibilities are not limited to these but pertain to the majority of responsibilities. Verifying registration information and eligibility, registering and doing global updates if needed to maximize reimbursement to the Hospital and keeping track in joint databases are all inclusive. Resolving billing issues as expeditiously as possible.

Responsibilities encompass three major areas of functionality.

FINANCIAL INFORMATION

• Ensure that patient registrations and billing information is complete and accurate in our Registration system. Obtain, verify and record personal, demographic and financial information. Contact patient if demographic information is not complete or if there are discrepancies or missing information.
• This position is responsible for the financial application process which includes but not limited to: assessing eligibility and completing a Virtual Gateway application or a manual application (according to protocol), assisting patients with payment plans, assisting those on Medicare with Part D as needed, updating all databases associated with their work and working closely with OB to ensure coverage and communication.
• Conducts patient interviews in person. Must extract sensitive personal data, including financial status, liquid/fixed assets, in order to determine eligibility. Must be able to contact patients over the phone or be able to draft letters to send to patients.
• Must possess a vast array of knowledge of criteria around each type of Government/State Program. Must be able to enter accurate information into PFS database as well as the electronic Virtual Gateway as well as other databases PFS utilizes. Must be able to do redeterminations/reviews according the protocol.
• In addition, must be able to assist patient on a financial payment plan if the patient does not qualify for services and has past balances. Must be able to work with various levels of an organization including providers, administrators, staff as well as patients. Working with difficult patients is a skill in customer service that is necessary.
• Must be able to assist with the preparation of a presentation, present services to a public audience and be able to answer questions on the particulars of Mass Health, HSN, Healthy Start, CMSP Commonwealth Care/Choice as well as other services that are available.
• Ability to train others to do this role.

PATIENT REGISTRATION

• Must be fully trained in all Hospital registration systems and able to do full registrations.
• Obtain and record all required registration information from new patients and updates for existing patients, for billing and statistical purposes. Enters information into current registration system.
• Verifies and updates patient registration information for patients who have been previously seen at the Health Center.
• Conducts follow up research to obtain information not obtained at time of registration, as required. Ability to conduct an eligibility check on the best system to validate coverage. May call insurance companies depending upon circumstances.
• References patient index when more than one unit number is found in the system. Assigns unit numbers or determines existing unit number according to Health Center and Hospital protocols. Ability to change phone numbers and addresses and monitor guarantor address as well. Prints Blue Cards as needed.
• Can fill in for Registrars as needed and must be able to do a complete registration and assist patients in determining next steps for billing questions.

CUSTOMER SERVICE

• Assist patients with billing issues/concerns as it relates to all payers. Call Customer Service, the Insurer and possibly others to determine the reason for the charges. Counsel/educate//advise patients of options available to remedy billing if applicable.
• May assists insured patients in deciphering their MGH or MGPO bills to determine whether they require further assistance. Call the Customer Service number on the back of their bill as a first course of action. Discuss difficult payment issues; determine appropriate course of action as needed.
• May answer any diverse questions from patients, physicians, and carriers, cross reference information with multiple sources and may need to do independent research. A call back to patient/carrier/customer service may be necessary.

Other duties as necessary.

Qualifications

QUALIFICATIONS:

• High School Diploma or GED required. Associate/Bachelor's Degree preferred.
• Experience in a hospital setting preferred
• Basic computer skills
• Exceptional customer service skills
• Ability to exercise judgment in dealing with sensitive and confidential information
• Strong teamwork skills, Ability to work independently.

EEO Statement

Massachusetts General Hospital is an Affirmative Action Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment.