
Patient Business Representative
Job Description
Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.
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.
Qualifications
ABOUT BROOKSIDE COMMUNITY HEALTH CENTER:
Brookside is a licensed Community Health Center of Brigham and Women's Hospital and provides multi-disciplinary, comprehensive care with services in a range of medical areas including Adult, Family and Pediatric Primary Care, OB/GYN, Family Planning, Dental/Oral Surgery, Nutrition/WIC, Behavioral Health and Specialty Medicine (Cardiology, Pulmonology and Nephrology). Brookside also has a Laboratory onsite, Financial Counseling and Community Resource Specialists. Each year, more than 11,000 patients from Jamaica Plain, the city of Boston and surrounding areas use these services, producing more than 69,000 visits to Brookside each year. Most of Brookside’s patient population are Spanish speaking and socioeconomically underserved. The health center's services, guided by equity, are provided by a bilingual English/Spanish medical and professional staff. Brookside is a teaching site for Harvard Medical School, Mass General Institute of Health Professionals School of Nursing, Harvard Dental School, Boston University Dental School, as well as other Boston area health care professional programs.
Education
High School Diploma/GED required
Bachelor's Degree Health Administration / bachelor's degree Related Field of Study preferred
Part time 20-hours
Bilingual / Spanish required
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.
Additional Job Details (if applicable)
Remote Type
Work Location
Scheduled Weekly Hours
Employee Type
Work Shift
Pay Range
$19.81 - $28.30/Hourly
Grade
3
EEO Statement:
Mass General Brigham Competency Framework
At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.