Care Navigator

Essential Functions

• Utilize professional and courteous communication to greet patients when answering phone calls and responding to their inquiries.
• Review and manage recall appointments and no show/cancellation reports.
• Promptly and professionally route phone calls to appropriate personnel via direct transfer, paging, voicemail, or redirect as needed.
• Retrieve and appropriately route any messages from the answering service.
• Perform registration functions for new or existing patients and activate patient files.
• Effectively collect and record copayments as required.
• Provide advanced financial support to patients and colleagues regarding claim and billing inquiries.
• Retrieve and process prior authorizations.
• Verify patient insurance eligibility and clearly communicate benefit limitations.
• Absorb and provide support to patients and medical staff as needed.
• Work collaboratively with clinical colleagues, management, and other staff to ensure efficient practice operations.
• Ensure accurate and detailed documentation of patient encounters.
• Ensure compliance with all Standard Operation Procedures (SOP's) and policies (including HIPAA & OSHA).
• Adhere to practice policies, procedures, and protocols.
• Participate in team meetings and contribute to quality improvement initiatives.

Skills

• Excellent customer service skills that include written and verbal communication.
• Ability to handle high call volume in a productive manner and know when to escalate issues.
• Ability to multitask and work in a fast-paced environment.
• Careful and empathetic attitude towards patients.
• Demonstrate time management skills by efficiently prioritizing tasks and patients simultaneously.
• Demonstrate professionalism, a high quality of work, collaboration, goal attainment, attention to detail, self-motivation, and productivity in a remote capacity.
• Proven ability to work collaboratively within a team environment.
• Highly adaptable and willing to adjust to changing priorities and conditions.

Experience And Education

• A High School Diploma or equivalent required.
• Minimum 1-2 years of customer service experience.
• Call Center experience preferred, but not required.
• Computer proficiency, including programs such as MS Office, Word, Excel, email and internet research.
• Knowledge of HIPAA and Insurance Payors.
• Experience navigating healthcare insurance operations, including benefit verification, prior authorizations, referrals and patient collection.
• Experience with electronic health records (EHR) systems preferred, but not required.