Patient Navigator Job – Dallas, TX

Our culture at Prism Health North Texas is built on our shared Core Values. We make hiring, firing, promotion, and performance review decisions based on these values and behaviors, so it is important that you also share these Core Values:

• We are solution seekers.
• We have a can-do attitude.
• We are mission-driven.
• We care about people.

About the role

The Financial Navigator manages eligibility and insurance verification for patients. The goal is to provide continuous documentation support by helping patients maintain eligibility requirements for service continuity. The Financial Navigator works with patients to determine the payor source that should be used for the patient.

Responsibilities

• Meets 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 any related notes in the EHR.
• Uploads eligibility documentation and agency documents into document portal and EHR.
• Conducts insurance verification, eligibility, and benefits before each medical visit and ensures all prior authorization is complete prior to delivery of ambulatory practice services.
• Assists patients in understanding insurance benefits and patient financial responsibilities prior to services being rendered.
• Manages a patient’s health record to ensure that all required information is correct and complete in the Prism Health North Texas (PHNTX) system, and information is available to provide services.
• Refers patients identified with multiple needs to clinic case managers for assessment.
• Other duties as assigned.

Requirements

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

Skills

• Proficiency in Excel, Word, and Outlook.
• Demonstrated knowledge and experience working with clients with mental health and substance use disorders.
• Demonstrated ability to handle multiple responsibilities to meet tight deadlines in a complex environment.
• Demonstrated knowledge of physician reimbursement, medical terminology, ICD-10, CPT, and HCPCS coding.
• Ability to make decisions related to appropriate client care.
• Ability to effectively communicate in verbal and written formats.
• Ability to establish effective working relationships with clients.
• Ability to manage and work effectively in the required electronic medical record, database, or document portal.
• Ability to work in a multi-site work environment.