Financial Navigator Job – Dallas, TX

About the Role

The Financial Navigator manages eligibility and insurance verification for patients, ensuring continuous documentation support to help patients maintain eligibility requirements for service continuity. The role involves working with patients to determine the appropriate payor source and assisting them in understanding insurance benefits and financial responsibilities.

Responsibilities

• Meets with patients to complete eligibility documentation.
• Maintains eligibility documentation for new and existing outpatient medical care patients.
• Responds to patients’ communication in a timely manner to prioritize eligibility maintenance.
• Documents eligibility status and related notes in the EHR (Electronic Health Record).
• Uploads eligibility documentation and agency documents into the document portal and EHR.
• Conducts insurance verification, eligibility, and benefits checks before each medical visit, ensuring all prior authorizations are complete prior to service delivery.
• Assists patients in understanding insurance benefits and patient financial responsibilities before services are rendered.
• Manages patient health records to ensure all required information is correct and complete in the Prism Health North Texas (PHNTX) system.
• Refers patients identified with multiple needs to clinic case managers for assessment.
• Performs other duties as assigned.

Requirements

• Proficiency in Excel, Word, and Outlook.
• Demonstrated knowledge and experience working with clients with mental health and substance use disorders.
• Ability to handle multiple responsibilities and meet tight deadlines in a complex environment.
• Knowledge of physician reimbursement, medical terminology, ICD-10, CPT, and HCPCS coding.
• Ability to make decisions related to appropriate client care.
• Strong verbal and written communication skills.
• Ability to establish effective working relationships with clients.
• Experience working with electronic medical records, databases, or document portals.
• Ability to work in a multi-site environment.

Qualifications

• A high school diploma or GED.
• 5 years of experience in insurance verification and billing in a comprehensive and specialty care environment.
• Experience working with third-party billing services preferred.
• Certification in coding and billing preferred.
• Bilingual in English/Spanish is preferred.