Sleep Wellness Pt Navigator

About the role

Acts as patient navigator to set up appointments, obtain referrals, related medical records. Performs benefit investigation.

Responsibilities

• Responds to all incoming calls for Sleep patients; schedules appointments, billing and insurance inquiries.
• Schedules DME setups and coordinates between patient, department and DME or required DME vendor based on patient zip code.
• Works with FCC on authorizations for home sleep tests; tracks orders and authorizations while maintaining communication with patients during this process.
• Processes orders for CPAP machines and supplies, including required paperwork, forms, and sending medical records to DME vendor to ensure insurance coverage.
• Works with Sleep Educator to schedule patient once DME equipment is approved and received.
• Coordinates provider appointments after equipment is received, ensuring patients are seen between 31 and 90 days per Medicare guidelines to avoid non-compliance.
• Acts as Customer Service Representative for sleep patients, addressing concerns related to equipment, coverage, or benefits and relaying information to physicians, clinical staff or DME company as indicated.
• Schedules peer-to-peer insurance reviews and submits all paperwork for insurance/coverage appeals for insurance denials.
• Investigates and tracks charts for sleep studies and machines to facilitate payment through DME company.
• Performs other duties as assigned by the Sleep Wellness Coordinator.