PAS Financial Counselor

Under the general direction of the Financial Counseling Supervisor/Manager and/or Financial
Clearance Director, the Financial Counselor (Certified Application Counselor) provides a key role
in providing a health care coverage needs assessment with patients, community applicants, and
family members. Determines eligibility for MassHealth, Qualified Health Plans, Children’s Health
Insurance, Health Safety net and any other coverage that they may qualify. Provides guidance and
assistance to patients, various internal UMass staff, physician offices and third-party vendors
regarding financial assistance programs.

Major Responsibilities:
1. Interviews, screens and assess applicants and family members in a variety of on campus 
locations utilizing income and household composition and other criteria in accordance with 
CMS and other governmental established guidelines for program eligibility. 
2. Determines qualification for affordable health insurance coverage, including the application of 
advance premium tax credits (APTC), premium assistance programs, Medicare Savings Plans 
and any other program they may be determined eligible. 
3. Interacts with patients, the community, and outside agencies in a professional manner in 
keeping with the Mission and Vision of UMMHC. 
4. Facilitates enrollment through the online Health Connector Health Insurance Exchange (HIX) 
or any other program application by accurate and timely submission of necessary paperwork 
according to state and federal regulations and policies. 
5. Follows up with patients in person or by telephone to obtains appropriate confidential financial 
and medical information on incomplete applications.to establish eligibility for various 
financial assistance programs.
6. Acts as the liaison for patients with MassHealth, the Health Connector and the Health Safety 
Net to assist in the resolution of eligibility discrepancies, applications status updates, and any 
other issue that may arise in the determination process. 
7. Facilitates patient understanding of health access options including but not limited to 
eligibility rules, coverage types, enrollment periods, products and plans available through 
MassHealth, the Health Connector, Medicaid Managed Care, and the Health Safety Net 
program.
8. Responsible for coverage of the Financial Counseling call center to act as a resource for 
patients and families, members of the community, clinical departments and other Revenue 
Cycle departments with insurance coverage issues and questions.
9. Provides and documents price estimates request to patients in accordance with federal price 
transparency regulations. 
10. Works within EPIC work queues to identify and reach out to uninsured/underinsured 
patients/families (inpatient, outpatient, surgical day, psychiatric in patients, psychiatric 
outpatients, etc.) for the purpose of screening for assistance programs and upgrades to a richer 
benefit program.
11. Works in conjunction with clinical areas, interpreters, social workers, case managers, social 
security outreach workers, drug assistance coordinator, enhanced benefit coordinator, care 
mobile, physician/provider offices and community health centers as needed to ensure access to 
care and timely discharge planning. 
12. Discusses financial obligations with patients prior to elective surgical days or admissions. 
Communicates all information to provider offices and other Revenue Cycle departments. 
13. Updates all accounts to reflect the current account status with appropriate financial class, 
eligibility dates, other patient financial and demographic information.

Standard Staffing Level Responsibilities: 
1. Complies with established departmental policies, procedures and objectives. 
2. Attends variety of meetings, conferences, seminars as required or directed. 
3. Demonstrates use of Quality Improvement in daily operations. 
4. Complies with all health and safety regulations and requirements. 
5. Respects diverse views and approaches, demonstrates Standards of Respect, and 
contributes to creating and maintaining an environment of professionalism, tolerance, 
civility and acceptance toward all employees, patients and visitors.
6. Maintains, regular, reliable, and predictable attendance. 
7. Performs other similar and related duties as required or directed. 

All responsibilities are essential job functions. 

III. Position Qualifications: 
License/Certification/Education: 
Required: 
1. High School Graduate. 
2. Certified Application Counselor (CAC)certification required within 45 days of hire as a 
condition of employment. 
3. Completes annual recertification and all mandatory ongoing training provided by the 
Massachusetts on-line Learning Management System and complies with privacy and 
security regulations that meet all federal program standards. 

Preferred: 
1. Associate or bachelor’s degree in Business, Social Services or related field. 

Experience/Skills: 
Required: 
1. Previous experience in healthcare, accounts receivable, Financial Counseling, medical 
billing, or a related field. 
2. Proficient data-entry and strong organization skills with attention to detail. 
3. Effective communication and customer service skills both verbal and written.
4. Ability to use specialized applications software and computers systems for patient 
registration and scheduling. 
5. Ability to work independently with strong problem resolution skills.
6. Must provide own transportation.
7. Ability to prioritize and work in high volume, fast paced, team-oriented environment. 
8. Ability to take directions and work independently.
9. English speaking, reading and writing skills

Preferred: 
1. Bilingual speaking, reading. 

Unless certification, licensure or registration is required, an equivalent combination of education 
and experience which provides proficiency in the areas of responsibility listed in this description 
may be substituted for the above requirements. 

Department-specific competencies and their measurements will be developed and maintained in 
the individual departments. The competencies will be maintained and attached to the departmental 
job description. Responsible managers will review competencies with position incumbents. 

IV. Physical Demands and Environmental Conditions: 

Work is considered light with frequent walking throughout the day. Position requires work 
indoors in a normal office and/or patient care environment. 

The Organization reserves the right to modify position duties at any time.