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Brookville & Freeport locations

Monday-Friday full time

Qualifications:

• Bachelor’s Degree preferred.
• Basic Life Support/AED certification.
• Strong oral, written and organizational skills required.
• Prior experience coordinating activities of a busy medical office or health care center, preferred.
• Proficient in computer applications (i.e. Microsoft Office - Word, Outlook, etc.).
• Knowledge of Electronic Medical Record (EMR), required
• Excellent patient service orientation.
• Ability to deal effectively with people and work in a team environment.
• Bilingual in both English and Spanish (orally and written), preferred

Primary duties and responsibilities include but not limited to:

The Patient Navigator identifies and links eligible patients and their families to primary care, mental health, restorative dental services, substance abuse treatment, specialty care and other required services. Insurance eligibility, prior authorizations and coordination of referrals are an integral part of this position to aid patients in coordination of their care.  In addition, this person will perform other duties as assigned on an as needed basis. 

• Linking patients to public health insurance programs, navigate the marketplace or securing appointment with managed plan facilitator.
• Assist providers with distribution of materials related to patient care and health education, in order to clarify and support provider instructions.
• Assist patients with appointment to specialists, at time of service.
• Track referrals in ECW, follow-up with patient and obtain consultant reports.
• Check eligibility on insurance portal, including listing as PCP/Dental Home.
• Check coordination of benefits (COB) by calling insurance companies.
• Fee collection, explanation of services and charges for patient services.
• Scrub daily claims for billing.
• Update referral list, periodically.
• Obtain pre-authorization for Behavioral Health Services.
• Facilitate patient care with other Advantage Care specialists, other FQHCs and community providers.
• Communicates effectively with team members, providers, nurses and administrative staff on potential barriers to care on specific patients.
• Obtain linkage agreements.
• Track and reconcile referral orders for Medical and Behavioral Health Services with follow up through completion.
• Minimum bi-monthly Cognos Reporting to the Practice Manager for Quality Assurance and Risk Management committees.
• Collaboration with Practice Manager and Clinical Nurse Manager  to identify and overcome barriers for successful referral completion
• Review patient panel for  Medicaid managed care plans and call patient to schedule an  initial appointment.
• Perform other duties, as assigned.