Patient Business Representative

About the Role

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

Responsibilities

• Screen patients for MassHealth, CarePlus, Connector Care, and Health Safety Net; assist in the application process when appropriate.
• Submit applications for Massachusetts 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 registration.
• Assist patients in applying for and understanding financial assistance programs or low-cost insurance plans, such as the Insurance Partnership, Medical Security Plan, and Health Connector Plans.
• Act as a patient representative for cases submitted via the Health Connector, paper, or phone, helping patients decipher notices from EOHHS.
• Assist 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.
• Act as a liaison between patients, the hospital billing department, and BWPO practices/billing agencies to address billing-related inquiries and issues.
• Accept and/or arrange payment for deductibles and outstanding balances.

Requirements

• High School Diploma or GED required.
• 1-2 years of registration or hospital patient billing experience preferred.
• Knowledge of healthcare billing and insurance terminology, including CPT codes, ICD-10 codes, and insurance claim processing.
• Excellent communication and interpersonal skills to interact professionally and empathetically with patients, families, and hospital staff.
• 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.

Additional Details

The primary location for this position is BWH Foxborough, MA, which offers free parking. Training will be onsite at the BWH Main Campus in downtown Boston (Francis Street). Candidates must commit to working Monday through Friday at the downtown location for approximately the first three months before transitioning to the Foxboro location.

Schedule

• Scheduled weekly hours: 40
• Work shift: Day
• Employee type: Regular
• Remote type: Hybrid
• Work location: 20 Patriot Place

Pay

Pay range: $19.81 - $28.30/hourly (Grade 3). Base pay is determined by skills, relevant experience, education, certifications, and other essential factors.

Benefits

In addition to competitive base pay, Mass General Brigham offers comprehensive benefits, career advancement opportunities, differentials, premiums, bonuses (as applicable), and recognition programs designed to celebrate contributions and support professional growth.