Patient Navigator (H)
On-siteMedley, Florida, United States
Job Summary
Conduct patient evaluations to obtain information necessary for treatment plan development and coordinate insurance and social service program access. Provide patient reminders, act as liaison between patients and providers, and identify and resolve barriers to care. Educate patients on health issues and maintain knowledge of community resources while ensuring accurate appointment scheduling and registration. Contact insurance companies to verify enrollment, deductibles, and authorization requirements, intervening as an advocate for prompt and efficient care. Maintain patient privacy per HIPAA standards and document all referral criteria and prior authorization details.
Required Qualifications
- High School diploma or equivalent
- Minimum 3 years of relevant work experience
- Ability to process and handle confidential information with discretion
- Ability to communicate effectively in both oral and written form
- Ability to handle difficult and stressful situations with professional composure
- Ability to maintain effective interpersonal relationships
- Ability to understand and follow instructions
- Maintain a working knowledge of medical symptoms, signs, and anatomical systems to identify and differentiate type and urgency of medical need
- Maintain knowledge of insurance referral requirements to ensure access based on third party reimbursement criteria
- Adhere to policies and procedures regarding appointment scheduling and registration processes, performing these tasks accurately with attention to detail to ensure the highest quality standards
- Adhere to standards provided by the HIPPA Privacy Office related to patient privacy and confidentiality
- Ability to contact insurance company through telephone; inquire about patient information and benefits
- Ability to inquire via insurance companies and HMO's about referral, authorization information and letters
- Ability to intervene as liaison/advocate for patients, physicians, and staff in facilitating ease of care
- Ability to assist in identifying trouble spots and problem patterns in the provision of care
- Ability to intercede for the patient as needed to obtain prompt, efficient, effective care (e.g. medical explanations, reduced waiting, billing inquiries, cost estimates)
- Ability to arrange any special needs such as transportation, interpreting services, etc... as needed for the patient's appointment
- Ability to facilitate financial support, assistance with paper work or medical records and linkage to follow-up services
- Ability to prepare routine departmental correspondence to referring agencies and primary care providers
- Ability to serve as a liaison between the patients, the UHealth Systems, Medical Providers in order to increase the utilization of appropriate primary care and tertiary services
- Ability to maximize patient use of appropriate and established health services
- Ability to assist and guide patients in receiving medical services
- Ability to educate patients on the appropriate utilization of care, appointments and treatments services
- Ability to ensure that patients are able to access and keep medical appointments
- Ability to set appointments and manage referrals as defined
Desired Qualifications
- Any relevant education, certifications and/or work experience
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