PATIENT ACCESS NAVIGATOR

SUMMARY:

Under the supervision of the Clinic Manager, the Patient Access Navigator supports patient-centered care by collecting important data, reviewing patient’s insurance status and providing first line customer service to ensure patients have appropriate access to medical, dental and behavioral health care. The Patient Access Navigator is also responsible for collecting and posting payments, scrubbing and completing billing batches on a daily basis, responding to billing inquiries from patients, and maintaining effective communication about billing-related matters with clinic staff, billing staff, and clinic management.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Maintains exemplary customer service skills with all patients, vendors, co-workers and all other clinic visitors.
• Provides support and is a vital member of SBNC’s Patient Centered Medical Home care teams.
• Checks in patients, registers new patients in Electronic Practice Management system (EPM) and verifies that patient’s program-specific eligibility is correct, up-to-date, and entered into the system accurately. Collects and accurately inputs data into the EPM system related to patient demographics, insurance status, social determinants of health and other data as the need arises in support of patient care and population health management.
• Collects proof on income and verifies patient family size and income and ensures that sliding fee scale information is complete, correct, and entered accurately into EPM.
• Ensures all appropriate consent forms are completed, signed, and scanned into the Electronic Health Record system (EHR).
• Asks patients if they are seeing other medical providers and helps to complete a medical records release form with patient in order to better coordinate care.
• Places patient in appropriate queue so the medical assistants begin their tasks.
• Answers all incoming calls by the third ring.
• Reviews next day’s schedule, consults with management regarding vacant spots, and prepares new patient registration packets as needed.
• Schedules patients for follow-up appointments based on patient need, care team standards of practice and availability to ensure that patients have timely access to care.
• Reviews and completes NextGen alerts on a daily basis for each patient encounter.
• Checks route slips or electronic health record system for completion and accuracy of charges
• Maintains balanced day sheets and receipts (cash, electronic check processing, and credit cards); reviews and submits clinic batches in a timely manner so that billing can be sent out on a regular basis.
• Interacts daily with medical and support staff to ensure proper education and updates are given to assist the billing department in clean claim submission.
• Reviews CHDP PM160 forms for completion and submission.
• Proactively proofs and corrects charges prior to submission for billing.
• Collects payments from patients and answers billing related questions.
• Processes insurance authorizations as needed.
• May assist in training other employees on billing-related duties.
• Keeps work area clean and orderly.
• Checks email upon arrival every morning and throughout the day to keep himself/herself informed of day to day functions and important communications with administration and clinic staff.
• May need to cover at other sites if needed.

OTHER DUTIES AND RESPONSIBILITIES:

1. Demonstrates understanding of and observe all SBNC policies, procedures, rules and regulations.
2. Demonstrates successful work-related behaviors.
3. Attends all required SBNC meetings and trainings.
4. Interacts with patients, physicians, staff, vendors, and visitors in a positive manner that reflects the SBNC mission and philosophy.

The above statements are intended to describe the general nature and level of work being performed by most people assigned to this job. They are not intended to be an exhaustive list of all responsibilities, duties, and requirements. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or it is a logical assignment to the position. The employee is expected to perform other duties necessary for the effective operation of the department.

QUALIFICATIONS AND EDUCATION REQUIREMENTS:

Education: High school diploma or equivalent.

Experience: Prior experience in a medical or dental care setting or related experience and/or training; or equivalent combination of education and experience.

Knowledge of: Use of standard software such as Windows, Word and Excel

Ability to: Speak fluent Spanish as well as English; provide outstanding customer service; follow verbal and written instructions; communicate effectively; use basic office equipment including computer, copy machine, fax machine, and postage meter; learn quickly in a fast-paced environment; interact diplomatically with staff and patients.

Preferred qualifications: Knowledge of medical terminology. Minimum keyboard speed of 45 WPM.

Physical Demands: May be required to lift objects weighing up to 20 pounds. Sitting in a normal seated position for extended periods of time. Reaching by extending hand(s) or arm(s) in any direction. Finger dexterity required to manipulate objects with fingers rather than with whole hand(s) or arm(s), for example, using a keyboard. Communication skills using the spoken word. Ability to see within normal parameters. Ability to hear within normal range. Ability to move about.

Certification/License: Valid Medical Assistant or Medical Billing and Coding Certificate from an accredited program preferred.

The physical demands described above are representative of those that must be met by an employee to successfully perform the essential function of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job unless providing such accommodations would result in undue hardship for the SBNC.

I understand and accept the duties and responsibilities as listed above.

Salary Range: $20 - $23 per hour