Specialty Navigator II

About the role

The role involves reviewing complex referral requests, assigning appropriate specialists, and coordinating care between Atrius Health and external partners. The position requires a strong background in healthcare and experience with managing patient interactions.

Responsibilities

• Reviews referral information from clinicians for pertinent information regarding tests, consultations, and procedures.
• Verifies demographics and insurance information.
• Works closely with Specialty Nurses to ensure clinical handoffs are safe and appropriate.
• Coordinates care both within Atrius Health and with external partners.
• Explains insurance benefits and options to patients.
• Keeps patients informed of the status of all referrals (approved and denied).
• Schedules patients for tests, consultations, services and procedures with other departments, local private offices, and/or outside vendors/providers.
• Answers phone calls, faxed requests and other inquires relating to referrals and communicates with the physicians and clinicians to acquire authorization or to inform them of patient issues or clinical paperwork needed.
• Manages complex patient interactions related to referral decisions, effectively de-escalating concerns while maintaining adherence to clinical and organizational standards.
• Promotes the Atrius Health System of Care by highlighting internal providers and their expertise.
• Trains and teaches as needed.
• Supports roles within the Navigator.
• Works with supervisors to ensure patients are receiving timely responses and detailed answers to their complex questions.
• Resolves billing and denied referral matters as they relate to the referral process.
• Contacts appropriate parties to obtain referral authorizations and verify coverage.
• Accesses only the minimum necessary protected health information (PHI) for the performance of job duties.
• Complies with all Atrius Health and departmental privacy policies, procedures and protocols.

Requirements

• High School Diploma/GED
• 3+ years of experience in a clinical or healthcare setting
• Intermediate level proficiency in Microsoft, scheduling software and electronic medical records systems (Epic or equivalent)

Qualifications

• Strong problem solving and complex patient management skills
• Relevant experience in the managed care environment
• A relevant degree in healthcare or a related field is preferred

Skills

• Intermediate level proficiency in Microsoft, scheduling software and electronic medical records systems (Epic or equivalent)
• Strong problem solving and complex patient management skills
• Relevant experience in the managed care environment

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

Pay

The hourly pay for this role will range from $18 to $32 per hour based on full-time employment. We comply with all minimum wage laws as applicable.

Schedule

FT, 40 hours. Monday - Friday, 8:30am - 5pm. This is a hybrid role, hybrid schedule to be determined by manager upon hire.

Location

1177 PROVIDENCE HWY NORWOOD, MA 02062