Patient Benefits Navigator

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We’re unique.  You should be, too.

We’re changing lives every day.  For both our patients and our team members. Are you innovative and entrepreneurial minded? Is your work ethic and ambition off the charts?  Do you inspire others with your kindness and joy?

We’re different than most primary care providers. We’re rapidly expanding and we need great people to join our team.

The Patient Benefits Navigator works directly with senior patients to ensure they are able to understand and effectively maximize their benefits in medical assistance programs and have access to health care for low/fixed income families and individuals. The incumbent in this role will help facilitate patient enrollment in both Medicaid and Medicare (Dual Eligibility) within our medical centers.The Patient Benefits Navigator works directly with senior patients to ensure they are able to understand and effectively maximize their benefits in medical assistance programs and have access to health care for low/fixed income families and individuals. The incumbent in this role will help facilitate patient enrollment in both Medicaid and Medicare (Dual Eligibility) within our medical centers.

ESSENTIAL JOB DUTIES/RESPONSIBILITIES:

• Conducts patient interviews and registration services explaining patient rights, medical releases and financial responsibilities; collects demographic documentation and financial data and initiates follow-up procedures when necessary.
• Identifies and shares, with patient and/or family member(s), opportunities to maximize medical benefits and, when necessary, arranges follow-up appointments to ensure appropriate guidance to health services and application timelines.
• Offers, educates and explains medical program options, insurance and financial services.
• Utilizes an Electronic Medical Records (EMR) system to gather and store patient information, respond to questions on behalf of the patient and appropriately and timely document patient issues and resolutions. Maintains assigned work queue of patient accounts.
• Assists patient and/or family member(s) with gathering medical records and/or information.
• Collaborates with insurance companies, healthcare providers and internal teams to verify information and understand all insurance and healthcare plan guidelines.
• Completes relevant patient documentation in compliance with all regulatory agencies, including HIPAA.
• Assists patients with questions and delivers extraordinary customer service via phone and email. Answers incoming telephone calls, makes out-bound calls and tracks all necessary paperwork.
• Liaises for medical center staff to collect information related to patient enrollments in medical assistance programs and to coordinate appointments between patients and providers.
• Presents the patient and family members with an exceptional quality of care and service experience with compassion, empathy, understanding, kindness and respect.
• Develops and maintains strong working relationships with internal and external organizations and contacts to ensure superior patient satisfaction.
• Performs other duties as assigned and modified at manager’s discretion.

KNOWLEDGE, SKILLS AND ABILITIES:

• Fundamental knowledge and understanding of local, state and federal healthcare benefit services and plans
• Ability to maintain exceptional customer service relationships with healthcare services agencies, patients, providers and peers
• Proven ability to make sound judgement decisions in a fast-paced, high energy, ever-changing environment
• Dependable and time conscience
• Willing to adhere to company expectations and policies regarding professional work environment and customer support
• Demonstrates professional integrity by being honest, reliable and respectful
• Ability to work effectively and efficiently with a team of professionals, as well as, independently
• Ability to develop and cultivate trusting relationships and provide sound guidance to patients
• Excellent listening and written and verbal communication skills
• Must have a positive overall outlook and take pride and care in work product
• Ability to perform multiple concurrent tasks with outstanding accuracy and skill
• Strong organizational, critical thinking, prioritizing and time management skills
• Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software
• Must be able to work and take appropriate action in a dynamic and challenging environment with minimal supervision
• Ability and willingness to travel locally, regionally and/or nationwide up to 10% of the time
• Spoken and written fluency in English required

EDUCATION AND EXPERIENCE CRITERIA:

• High school diploma or GED equivalent required
• Vocational training or similar college coursework in a related field preferred
• A minimum of 1 year of work experience in medical registration, billing or related field preferred
• Basic Life Support (BLS) certification desired

KNOWLEDGE, SKILLS AND ABILITIES:

• Fundamental knowledge and understanding of local, state and federal healthcare benefit services and plans
• Ability to maintain exceptional customer service relationships with healthcare services agencies, patients, providers and peers
• Proven ability to make sound judgement decisions in a fast-paced, high energy, ever-changing environment
• Dependable and time conscience
• Willing to adhere to company expectations and policies regarding professional work environment and customer support
• Demonstrates professional integrity by being honest, reliable and respectful
• Ability to work effectively and efficiently with a team of professionals, as well as, independently
• Ability to develop and cultivate trusting relationships and provide sound guidance to patients
• Excellent listening and written and verbal communication skills
• Must have a positive overall outlook and take pride and care in work product
• Ability to perform multiple concurrent tasks with outstanding accuracy and skill
• Strong organizational, critical thinking, prioritizing and time management skills
• Proficient in Microsoft Office Suite products including Word, Excel, PowerPoint and Outlook, plus a variety of other word-processing, spreadsheet, database, e-mail and presentation software
• Must be able to work and take appropriate action in a dynamic and challenging environment with minimal supervision
• Ability and willingness to travel locally, regionally and/or nationwide up to 10% of the time
• Spoken and written fluency in English required

EDUCATION AND EXPERIENCE CRITERIA:

• High school diploma or GED equivalent required
• Vocational training or similar college coursework in a related field preferred
• A minimum of 1 year of work experience in medical registration, billing or related field preferred
• Basic Life Support (BLS) certification desired

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