JOB SUMMARY:

Responsible for the timely and accurate financial counseling of uninsured or underinsured patients. Responsible for assisting the patient in applying for Pennsylvania Medical Assistance, the Health Insurance Exchange Marketplace and UPMC Financial Assistance Program.

• Perform duties and job responsibilities in a manner which promotes the core values of UPMC (Quality and Safety, Dignity and Respect, Caring and Listening, Excellence and Innovation, Responsibility and Integrity) in all consumer and UPMC interactions.
• Assist uninsured or underinsured patients with obtaining health care coverage with either the Health Insurance Exchange Marketplace or Pennsylvania Medical Assistance.
• Counsel patients and their families, in a hospital setting regarding the resources available.
• Utilize the Medical assistance/Financial Assistance Screening tool with patients when applicable.
• Submit Medical Assistance Presumptive Eligibility applications with the mandated requirement of five days.
• Assist patients with applying for UPMC Financial Assistance Program.
• Ensure that all the regulatory and financial requirements are met.
• Assist patients with explaining their insurance benefits.
• Assist patients with other methods of financial counseling, i.e., explaining insurance benefits, requesting price estimates and setting up payment plans.
• Monitor the various work lists and work queues to ensure the appropriate follow-up within the expected time periods.
• Resolve complex outstanding patient issues.
• Conduct daily review and analysis of accounts flagged for review.
• Assist with inquiries from walk-in patients regarding billing problems in conjunction with the Patient Financial Services Department.
• Perform benefit education and financial counseling on potential out of pocket expenses for patients who have services scheduled.
• Maintain department productivity levels.
• Maintain compliance with quality standards.
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• Performs in accordance with system-wide competencies/behaviors.

• Performs other duties as assigned.
• High School diploma or equivalent and 5 years’ experience,
• OR Bachelor’s degree and 1 year experience required.
• Bachelor’s degree in a related field, Business Administration or Social Work preferred.
• Must be proficient in at least 2 patient accounting systems such as EPIC, Medipac, AIM and/or Invision.
• Strong PC and computer skills required.
• Must possess excellent communication and customer service skills.
• Must display leadership skills.LICENSURE, CERTIFICATIONS, AND CLEARANCES:
• Act 31 Child Abuse Reporting with renewal
• Act 33 with renewal
• Act 34 with renewal
• Act 73 FBI Clearance with renewal