Boston Medical Center (BMC)

Counselor

• Under the general direction of PFC Manager, the Outpatient Financial Counselor (OPFC) has a dual role to help vulnerable BMC patients to access healthcare coverage and to preserve and protect BMC revenue by securing payors to reduce uncompensated care.
• The OPFC serves as an advocate and navigator, assisting low-income, uninsured and underinsured patients apply for financial assistance programs and secure healthcare coverage.
• Assist patients referred for financial counseling, in person or by phone, from PFC office locations on the hospital campus.
• Screen patients presenting for services, by appointment or walk-in, for eligibility and offer enrollment assistance to secure insurance coverage through MassHealth, Out of State Medicaid, HSN, or BMC’s Charity Care Program.
• Responsible for initiating new applications and assisting with program renewals; educating patients about health insurance options and eligibility requirements; updating patient demographic information, opening financial trackers, and documenting all efforts made to assist patients in applying for insurance coverage.
• Maintain daily written reports of work activity to document patient enrollments and outcomes; patient complaints and resolutions; patient declinations, etc.
• Provide education and advisement on health insurance options and enrollment requirements for other hospital departments, community health centers, community leaders and other personnel as needed.

Outpatient Financial Counselor

• Under the general direction of PFC Manager, assist vulnerable BMC patients to access healthcare coverage
• Serve as an advocate and navigator for low-income, uninsured and underinsured patients
• Educate patients about health insurance options and eligibility requirements
• Initiate new applications and assist with program renewals
• Complete MassHealth’s curriculum for Certified Application Counselor and renew certification annually
• Provide in-person assistance to offer outreach and education or initiate new applications or plan renewals

Application Counselor

Analyst

• Align technology solutions with business strategies.
• Proactively identify opportunities to apply technologies to business processes.
• Inform and advise customers on information system technologies' functionality, costs, benefits, and implementation requirements.
• Function as technical liaison and broker of services with various vendors.
• Act as internal consultant, providing technical guidance or business process expertise on the most complex projects.
• Research strategic planning matters from a technical or business standpoint.
• Develop and maintain credibility and effective working relations with both customer management and IT personnel.
• Demonstrate an understanding of business problems, as well as IT strategies, issues, and priorities.
• Seek opportunities to apply technology to improving business processes within strategic system goals.

Applications Analyst III – Senior Level

Project Manager

• Works with internal and external contacts to organize the various components needed to initiate, run and conclude a major project
• Duties include coordinating schedules and activities, placing orders for supplies and services, and tracking progress and results
• Initiates projects and establishes collaborative relationships among various project and constituent groups
• Develops and maintains a detailed project schedule and participates in implementation and ongoing project meetings
• Reviews, monitors, and tracks progress towards project completion; maintains records and assists in preparing reports
• Ensures coordination of the interfaces between departments and stakeholders
• Identifies and works to remove barriers to successful project completion
• Provides timely project status updates to Directors and executive leadership
• Finalizes all activities across process groups to formally close the project or project phase

Project Coordinator, Psychiatry Research – Imani Breakthrough Project

Manager

• Manage all financial reporting and budgeting for hospital volume and gross charges
• Collaborate with the Reimbursement team to analyze net revenue trends
• Define the analytical standards, methodologies, and frameworks for accuracy and integrity of financial outputs
• Produce detailed volume and revenue forecasts for new initiatives
• Analyze and interpret budget variances to provide necessary context to performance drivers

Manager – Volume and Revenue Analytics

• align technology solutions with business strategies
• identify technology opportunities for business processes
• inform and advise customers on information systems
• act as technical liaison with vendors
• maintain credibility and effective relations with management and IT personnel
• apply technology to improve business processes

HIM EHR/Application Analyst II

• Responsible for management of the Decision Support (cost accounting) system for the hospital and affiliated medical group
• Oversee service line analytics and growth strategies across Boston Medical Center
• Act as a key consultant to finance and operational leaders on the requirements of new businesses and programs
• Serve as critical support throughout implementation
• Develop consistent and accurate analysis and business proposals using data driven solutions and proactive planning
• Assist in development of robust hospital service line analytics and benchmarks
• Train and mentor junior staff across the Service Line Planning and Business Development team
• Develop best practices for the department

Senior Manager – Decision Support

• Perform operational, technical, and administrative duties
• Review existing laboratory operations across Community Health Centers
• Explore and evaluate improvements for operations or service models
• Troubleshoot laboratory operations issues
• Ensure coordination of lab operations, IT systems, and quality improvement projects

Outreach Manager – Community Health Center Labs

• Under the general direction of PFC Manager, help vulnerable BMC patients to access healthcare coverage
• Serve as an advocate and navigator for low-income, uninsured and underinsured patients
• Respond to call center inquiries and manage self-pay patient work ques
• Screen for eligibility and provide enrollment assistance for insurance coverage
• Educate patients about health insurance options and eligibility requirements
• Document all efforts made to assist patients in applying for insurance coverage
• Validate and update active insurance coverage in the hospital registration and billing system
• Collect and post payments for self-pay balances
• Assist patients with billing questions or concerns
• Maintain daily written reports of work activity

Accounting Manager

• Manage day-to-day accounting activities related to the physician organization entities of BUMG and BMCAP
• Oversee month-end close, general ledger maintenance, reconciliations, and internal financial analysis
• Collaborate with various operational leadership groups to ensure accurate data flow
• Support financial close processes by coordinating journal entries, reconciliations, and variance reviews
• Lead a team of accountants to ensure the integrity of financial data

Associate Director, Accounting

• Manage all financial reporting and budgeting for hospital volume and gross charges
• Collaborate with the BMC Reimbursement team to analyze trends in net revenue
• Create and present comprehensive and complex financial models that flex with volume
• Oversee volume statistical reports provided to executive and senior management and external stakeholders
• Assist in creation of annual hospital volume and charge budgets
• Investigate and explain variances from budget for weekly and monthly reports
• Incorporate statistical and volume data into revenue modeling and business planning
• Maintain integrity of volume and revenue reporting within comprehensive financial reporting tools
• Create standard operating procedures and/or data manuals to ensure consistency in reporting
• Serve as a key liaison with operations to understand operational challenges
• Work with operations to optimize resource utilization within the hospital
• Create detailed volume and revenue forecasts for programs or new initiatives
• Conduct market research and financial analysis that impact business plans and strategies

Manager of Volume and Revenue Analytics

• Under the general direction of PFC Manager, assist vulnerable BMC patients to access healthcare coverage
• Serve as a financial counselor, advocate, and navigator for low-income patients
• Respond to call center inquiries and manage self-pay patient work queues
• Educate patients about health insurance options and eligibility requirements
• Document patient efforts and assist with application initiation and renewals
• Maintain patient confidentiality and secure tracking of financial assistance applications
• Participate in regular staff meetings and scheduled training to maintain required core competencies

Certified Application Counselor

• Provide leadership and strategic direction for daily operations of Patient Access Services
• Manage staff performance and productivity
• Develop, mentor, and provide ongoing education to department personnel
• Establish, implement, and maintain policies and procedures
• Monitor and report departmental key performance indicators (KPIs)
• Ensure compliance with regulatory requirements
• Maintain collaborative relationships with clinical and departmental leadership
• Oversee departmental fiscal management
• Commit to continuous professional development
• Perform other duties as assigned

Manager, Patient Access Services, ED & Main Admitting

Medical writer

• Provide clinically based prospective, concurrent, and retrospective reviews of medical records for WellSense of members enrolled in value-based agreements
• Review risk adjustment gap lists for members, including suspect conditions
• Perform chart reviews to determine clinical validity of open gaps
• Utilize Physician documentation queries to communicate clinical indicators to Physicians/Other Qualified Health Care Providers
• Facilitate appropriate physician documentation of care delivery to accurately reflect patient severity of illness and risk of mortality
• Track and Trend CDI findings and provider engagement for clinical documentation education purposes for any specialty within the hospital system

Outpatient Clinical Documentation Specialist

Operations

• Provide coding oversight and standards to ensure coding accuracy, compliance and appropriate reimbursement across BUMG.
• Manage operational execution of coding standards in areas reporting to Revenue Cycle.
• Facilitate accurate representation of professional coding and clinical documentation through interaction with physicians, coders and practice staff by providing ongoing education.
• Direct coding activities to ensure accurate, consistent and compliant coding for all services.
• Ensure quality reviews to validate coding accuracy.
• Participate in the rejections, denials and claims review process with billing team to ensure compliance and accurate reimbursement.
• Identify trends in documentation and coding concerns and collaborate with Leadership and Compliance to assess and implement corrective action.
• Evaluate the success of coding processes on an ongoing basis.
• Serve as contact for professional coding across BUMG.
• Work with Human Resources and department managers on the selection of qualified candidates for employment following all policies, guidelines and applicable laws.
• Responsible for effective personnel management including training, directing, mentoring and instilling a commitment to quality and excellence.
• Monitor department productivity and performance to identify and evaluate program/department strengths and training opportunities in relation to operative effectiveness.
• Encourage staff and personally advances professional growth and development through participation in educational programs, workshops and maintaining knowledge of industry standards and practices.

Outpatient Financial Counselor

Application Counselor

Applications Analyst III – Senior Level

Project Coordinator, Psychiatry Research – Imani Breakthrough Project

Manager – Volume and Revenue Analytics

HIM EHR/Application Analyst II

Senior Manager – Decision Support

Outreach Manager – Community Health Center Labs

Outpatient Financial Counselor

Associate Director, Accounting

Manager of Volume and Revenue Analytics

Certified Application Counselor

Manager, Patient Access Services, ED & Main Admitting

Outpatient Clinical Documentation Specialist

Director, PB Coding Operations – Education