Site: The Brigham and Women's Hospital, Inc.

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Job Summary

Summary:

The Patient Business Rep (PBR) functions as a financial counselor and registrar and is responsible for the in-depth evaluation of financial history for both uninsured and underinsured patients for the purpose of determining eligibility for government and pharmacy financial assistance programs. The PBR will serve as the primary practice contact when patients require assistance with various billing/financial related issues.

Does this position require Patient Care? No

Essential Functions:

-Responsible for screening patients for MassHealth, CarePlus, Connector Care, Health Safety Net, assisting in the application process when appropriate.

-Submits applications all Massachusetts applications for health coverage via the Health Connector.

-Verify patients' insurance coverage and eligibility to ensure accurate billing and claims processing.

-Collect and record patient demographic and insurance information accurately during the registration process.

-Assists patients in applying for and/or understanding all other financial assistance programs or low cost insurance plans such as the Insurance Partnership, Medical Security Plan, and Health Connector Plans.

-Acts as patient representative in any cases submitted via the Health Connector, paper or over the phone, assisting the patient in deciphering notices received from EOHHS.

-Assists patients in the redetermination process for MassHealth, Connector Care and or Health Safety Net.

-Offer financial counseling and assistance programs to patients who may require financial support for medical services.

-Adhere to relevant billing regulations, insurance guidelines, and hospital billing policies to ensure compliance with healthcare laws and ethical standards.

-Acts as a liaison between the patients, hospital billing department and BWPO practices/billing agencies in addressing any billing related inquires and issues.

-Accepts and/or arranges payment for deductibles and outstanding balances.

Education
HS Diploma or equivalent required. Bachelor's Degree Health Administration or bachelor's degree Related Field of Study preferred

Bilingual in English and Spanish (strongly preferred)

Experience
Registration/Hospital Patient Billing Experience 1-2 years preferred

Knowledge, Skills and Abilities
- Knowledge of healthcare billing and insurance terminology, including CPT codes, ICD-10 codes, and insurance claim processing.
- Excellent communication and interpersonal skills to interact with patients, families, and hospital staff in a professional and empathetic manner.
- Strong attention to detail and accuracy in handling financial transactions and billing records.
- Ability to handle sensitive and confidential patient financial information with discretion.
- Problem-solving skills to address billing inquiries and resolve payment-related issues.

Physical Requirements

Standing Occasionally (3-33%)

Walking Occasionally (3-33%)

Sitting Constantly (67-100%)

Lifting Occasionally (3-33%) 20lbs - 35lbs

Carrying Occasionally (3-33%) 20lbs - 35lbs

Pushing Rarely (Less than 2%)

Pulling Rarely (Less than 2%)

Climbing Rarely (Less than 2%)

Balancing Occasionally (3-33%)

Stooping Occasionally (3-33%)

Kneeling Rarely (Less than 2%)

Crouching Rarely (Less than 2%)

Crawling Rarely (Less than 2%)

Reaching Occasionally (3-33%)

Gross Manipulation (Handling) Constantly (67-100%)

Fine Manipulation (Fingering) Frequently (34-66%)

Feeling Constantly (67-100%)

Foot Use Rarely (Less than 2%)

Vision - Far Constantly (67-100%)

Vision - Near Constantly (67-100%)

Talking Constantly (67-100%)

Hearing Constantly (67-100%)

Hybrid

640 Centre Street

40

Regular

Day (United States of America)

The Brigham and Women's Hospital, Inc. is an Equal Opportunity Employer. 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. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

Mass General Brigham Competency Framework