Senior Patient Financial Services Specialist

Role Overview

• Complete and submit MassHealth applications and renewals accurately and timely
• Assist patients, families and guarantors in gathering required financial documentation
• Resolve eligibility issues, denials, and coverage gaps
• Stay current with Massachusetts Medicaid regulations and policy changes
• Track and manage all resident MassHealth renewal dates on a rolling 12-month cycle
• Initiate renewal process upon receipt of MassHealth notices; monitor deadlines and follow up on outstanding documentation
• Verify insurance coverage and benefits across multiple payers in conjunction with admissions
• Collect, review, and organize required financial documents (bank statements, income verification, asset records, social security records, etc.)
• Determine ability to pay privately vs. eligibility for assistance programs
• Ensure accurate payer source assignment and billing readiness
• Educate patients, families and guarantors on coverage options, financial responsibility, and eligibility requirements
• Maintain accurate, complete, and audit-ready financial records
• Support internal and external audits related to billing and eligibility
• Follow up on unpaid claims, resolve discrepancies, and ensure timely payments
• Monitor and track accounts receivable, ensuring all payments are received timely

Requirements

• Associate’s or Bachelor’s degree in Healthcare Administration, Finance, or related field (preferred)
• 2–5+ years of experience in: Patient financial services, case management, or healthcare billing
• Massachusetts Medicaid (MassHealth) eligibility and applications
• Long-term care and hospital reimbursement
• Experience with financial document review and case management preferred