Medicare Premium Assistance Program Coordinator

University Of Massachusetts Medical School Charlestown , MA 02129

Posted 4 months ago



This is a benefited position that is funded through an Interagency Service Agreement (ISA) with the Executive Office of Health and Human Services (EOHHS) and the University of Massachusetts Medical School. Medicare Premium Assistance, also known as Medicare Buy-In, is a federal program that allows states to pay all or part of monthly Medicare premiums and cost sharing for eligible Medicare beneficiaries who meet income and asset guidelines. The Medicare Premium Assistance Unit within the Medicare Eligibility Enhancement Programs at the Center for Health Care Financing administers this program for the Massachusetts Medicaid program, MassHealth.

Under the general direction of the Senior Manager, the Medicare Premium Assistance Program Coordinator will assist in the coordination and management of the daily operations of the program and seek to maximize benefits available in private and public programs in order to preserve MassHealth as the payor of last resort.



  • Identify, evaluate, and coordinate Medicare Premium Assistance benefits for MassHealth members.

  • Interact with MassHealth members, providers, families, EOHHS staff, and state and federal agencies to coordinate Medicare Premium Assistance benefits as it relates to the member's eligibility.

  • Responsible for documenting and tracking all information associated with cases and reporting cost savings and caseload data.

  • Make appropriate referrals to various EOHHS units and federal agencies such as the Social Security Administration and the Centers for Medicare and Medicaid Services to coordinate functions as required.

  • Provide trainings to health care providers and other stakeholders on coordination of benefits with Medicare Premium Assistance.

  • Evaluate and update data information to maintain member Medicare coverage and premium payment status within the state Medicaid Management Information System (MMIS).

  • Correspond with internal and external stakeholders, including representatives of the Social Security Administration (SSA), Center for Medicare and Medicaid Services (CMS), the Railroad Retirement Board (RRB), and MassHealth Customer Service Center (CSC) and MassHealth Enrollment Centers (MECs) to provide information and resolve issues as needed.

  • Research payment transaction codes generated by SSA, CMS, and MMIS to accurately process member Medicare coverage and premium payments.

  • Provide direct customer service to MassHealth members including, but not limited to, answering, researching, and resolving inquiries in relation to Medicare coverage, eligibility and premium payments.

  • Represent the Medicare Premium Assistance Unit at member appeal hearings, as needed.

  • Investigate and resolve Medicare coverage, premium payment, and demographic exception cases.

  • Maintain, enhance and quality control existing systematic reports to capture exceptions and identify discrepancies.

  • Prepare internal reports and provide routine updates on productivity levels and status of assigned work.

  • Participate with MMIS technical team members in research and testing of change orders and Data Change Requests (DCR) to be implemented in MMIS.

  • Conduct business in accordance with approved standards and processes, including all data security and usage guidelines

  • Perform other duties as assigned



  • Bachelor's degree in Health Care Administration, or related field, or equivalent experience

  • 4 years relevant professional experience

  • Excellent oral and written communication skills.

  • Effective time management and customer service skills.

  • Ability to interpret state and federal laws and regulations

  • Strong attention to detail

  • Demonstrated ability to handle confidential information and to exercise judgment and discretion

  • Proficient in Microsoft Word, Excel, and Access.

Additional Information


  • Previous insurance or benefit coordination experience

  • Knowledge of rules and regulations of the Medicare and MassHealth programs

  • Previous experience communicating professionally and effectively with public sector personnel, businesses, legal representatives, or private citizens

  • Bilingual skills

icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Program Manager

Massachusetts General Hospital

Posted 6 days ago

VIEW JOBS 10/15/2019 12:00:00 AM 2020-01-13T00:00 GENERAL SUMMARY/ OVERVIEW STATEMENT: The Division of Neuropsychiatry and Neuromodulation at Massachusetts General Hospital and Harvard Medical School is a clinical neuroscience division with a focus on brain circuitry that integrates clinical care (e.g. TMS clinical service, Neuropsychiatry clinics), neuroscience research (basic, translational and clinical) and training (e.g. clinical and research fellowships, residents, graduate students). Receiving supervision from the chief of the Division, the Program Manager is responsible for overseeing the daily operations of the MGH Division of Neuropsychiatry and Neuromodulation and supporting its growth. This position will utilize strategic planning, project management, and communications to provide ongoing support for all aspects of the Neuropsychiatry and Neuromodulation strategic initiative and its expansion. Specifically, the Program Manager will provide ongoing managerial support to the Transcranial Magnetic Stimulation (TMS) clinical service, the Neuropsychiatry clinics, the Laboratory of Neuropsychiatry and Neuromodulation the Behavioral Neurology-Neuropsychiatry (BN-NP) Fellowship and the Interventional Neuropsychiatry Fellowship. Must be a high performer with well-developed organizational, analytic and communication skills capable of working independently with minimal supervision and guidance. This position will collaborate closely with and support clinician and administrative leaders in multiple hospital departments, including but not limited to the Departments of Psychiatry, Neurology and Radiology. PRINCIPAL DUTIES AND RESPONSIBILITIES: General Management and Facilitation * Develops and implements, in collaboration with Neuropsychiatry and Neuromodulation clinicians, a vision for programs and services that meet the support and treatment needs of our patients and research subjects. * Support clinical and administrative staff to ensure each clinic runs smoothly and to ensure progressive steps toward organizational and programmatic consistency and sustainability * Provide supervision of support staff (5.0 FTE: one administrative coordinator, four clinical research coordinators and TMS technicians) to ensure that clinical patients and visitors are scheduled, greeted, checked in, and attended to appropriately before, during, and after each visit. * Develop workflows, processes, and procedures to improve operational efficiency and effectiveness of this program. * Oversees group practice and third-party credentialing/ enrollment issues. * Ensures adequate staffing for all clinical areas including cross-coverage, vacations, and leaves of absence. * Provide leadership and project management, including team facilitation, benchmarking, data capture and analysis, qualitative metrics, redesign implementation and evaluation. * Develop all marketing plans and collateral including brochures, newsletters, marketing emails and website event pages. * Design, develop, implement and manage performance tracking systems * Manage the hiring process for administrative staff and conduct performance evaluation for the administrative coordinator and clinical research coordinators. * Resolve problems; work with staff to identify and implement system improvements. * Work closely with the clinical director of the program; meet regularly concerning programmatic, operational and office management activities and issues. * Work collaboratively with leadership of the Department of Psychiatry. * Assist with training and certification process for all personnel. * Manage all space related issues including relocations, renovations, and ongoing maintenance and security assessments; collaborate with Charlestown Navy Yard administrative coordinator and Department project manager, as necessary. Financial Management * Forecast, track expenses, and manage the clinical operating budget and various research funds. * Oversee financial aspects of the practices, including budgeting, professional & non-professional * Coordinate varying aspects of a multi-faceted program and oversee hospital-based and professional-based operations and revenue generation * Oversee purchasing for the entire Division of Neuropsychiatry and Neuromodulation. * Identifies and resolves errors of non-salary expenses * Works closely with the Hospital-Based and Professional Billing Offices on billing and collection for services. Provides financial modeling of new programs and clinics Clinical Programs Management * Support a team of 14 clinicians and provide assistance with billing and documentation issues. * Work with Department's Administrative Director for Clinical Operations to monitor monthly productivity and report monthly adjustments. * Ensure the efficiency of front desk operations including new patient scheduling/intakes through PAL and appointment authorizations. * Works closely with the Administrative Manager of Outpatient Services and external Hospital departments to ensure consistency and quality of practice/department access for clinicians, support staff and patients following established protocols, and ensuring compliance with Joint Commission, OSHA, HIPAA and Hospital guidelines. Research Program * Coordinate research assistants to support seven Principal Investigators with all grant proposals including the preparation of financial budgets and administrative sections of proposals. * Ensures correct and timely submission of grant proposals to sponsor organizations. * Monitors all budgets for conformity to sponsor regulations and MGH policies. * Assures compliance with all grants and related reporting. Fellowship Program * Provides administrative supervision and support to the Behavioral Neurology-Neuropsychiatry and Interventional Neuropsychiatry fellows. * Acts as a liaison between fellows and hospital administration when necessary. * Oversees fellow orientation and initial trainings. Along with the MGH GME office, informs residents and trainees of inter and intradepartmental policy and procedure changes. * Maintains the New Innovations web-based training tool to ensure compliance with fellowship evaluations and tracking Other * Perform special projects, as directed REQUIRED QUALIFICATIONS: * At least three years of related experience. * Bachelor's degree required, Master's degree preferred. * Prior managerial experience. SKILLS/ ABILITIES/ COMPETENCIES REQUIRED * Ability to analyze a variety of complex administrative and organizational problems and make sound policy and procedural recommendations. * Strong project management skills; experience in healthcare operations preferred (clinical, research or ideally both). * Ability to interact with all levels of the organization. * Skill with spreadsheets, project management tools, and databases. Must be thoroughly familiar with MS Office. * Must be analytical and exceptionally organized. * Must pay particular attention to detail and deadlines. * Must be able to multi-task, prioritize and work in a fast-paced environment. * Ability to work and make decisions independently. * Solid interpersonal skills are needed as well as the ability to work successfully as a member of a team in a large organization. WORKING CONDITIONS: * Full-Time (40 hours). Normal working conditions; Office setting, large tertiary academic hospital. SUPERVISORY RESPONSIBILITY: * Directly supervise 5.0 FTEs Massachusetts General Hospital Charlestown MA

Medicare Premium Assistance Program Coordinator

University Of Massachusetts Medical School