Patient Financial Counseling Team Lead, MGH

Job Summary

The Patient Business Representative Team Lead reports directly to the Manager of Financial Counseling. The PBR Team Lead, under the direction of the Manager, is responsible for all the responsibilities of the Patient Business Representative positions. The PBR function as a financial counselor and registrar and is responsible for the in-depth evaluation serving as an advocate and navigator, assisting low-income, uninsured and underinsured patients with applying for financial assistance programs to secure healthcare coverage. The PBR Team Lead will serve as the primary practice contact when patients require assistance with various billing/financial related issues, which cannot otherwise be resolved by the practice service representative.

The PBR Team Lead will have a strong working knowledge of all aspects of the billing/revenue cycle, managed care requirements, coding and compliance. Utilizing a variety of available resources and contacts the team lead counselor will assess and work towards the resolution of identified patient fiscal issues. The PBR Team Lead will work collaboratively with Case Management, Social Work, BWPO Practice Management, Patient Accounts, BWH Customer Service, Patient Relations, BWPO Billing Agencies, the Office of General Counsel, and State Agencies, e.g., EOHHS, DHCFP, etc.

In addition, the Patient Business Representative Team Lead will act as a department resource, which include assisting in the training of new hires, or the retraining of existing hires. The PBR Team Lead will act as lead for teams, as assigned, which can vary. The PBR Team Lead will assist the Management team in projects as necessary and assigned.

Qualifications

High School Diploma or Equivalent required or Associate's Degree Healthcare Administration preferred or Associate's Degree Related Field of Study preferred

Can this role accept experience in lieu of a degree? No

Experience in a healthcare setting, with a focus on patient access and registration 2-3 years required

Knowledge, Skills and Abilities

• Knowledge of patient access procedures, healthcare regulations, and insurance coverage.
• Excellent customer service skills, including active listening, empathy, and effective communication.
• Ability to prioritize tasks, work independently, and manage multiple projects simultaneously.
• Proficiency in Microsoft Office and electronic medical record systems.

Additional Job Details

Interpersonal relationship skills necessary to communicate effectively with patient/family, physicians and their support staff, medical staff, nursing staff, other hospital personnel and many external organizations and agencies. The technical knowledge of specific legal and regulatory requirements and an understanding of complex third party and medical assistance polices and procedures. Knowledge of the hospital information system with emphasis on accounts receivables programs. Ability to function independently and prioritize work within established policies.

Must complete MassHealth’s curriculum for Certified Application Counselor (CAC) and maintain certification renewal annually. Requires good judgment, tact, sensitivity and the ability to function in a stressful environment. Ability to maintain confidentiality regarding the patients, their medical histories, demographic and fiscal information, etc.