Patient Services Navigator
The Patient Services Navigator position plays a vital role in providing an exceptional patient experience as well as in securing financial benefits for both the patient and FHLC alike. This position is responsible for patient financial screening, insurance verification, enrolling patients in Marketplace as applicable, securing prior authorizations, tracking sliding fee scale patient screening, processing patient applications and track to completion, providing accurate patient expense estimates, financial counseling, pre-service collections, provider enrollment, and patient community benefit enrollment. The Patient Services Navigator acts as a liaison between patients and internal/ external partners to foster open, professional, timely, courteous, and accurate communication.
- Connects with patients via in person and/ or by telephone prior to their scheduled services to complete pre-registration, insurance coverage verification, sliding fee scale application, provide fee estimates, discuss resolution of financial obligations (including prior balances), collect any payments upfront, to financially secure patient account.
- Receives patient referrals from FHLC’s staff and interfaces regularly with medical and dental providers and support staff to provide patient financial assistance.
- Assist patients with navigating social services programs such as housing resources, food programs, legal services, transportation, etc., by helping them connect with community-based providers as applicable.
- Maintains CAC certification to enroll patients in Marketplace as applicable and assist with and Marketplace enrollment changes.
- Communicate with clinical staff and scheduling to notify of insurance authorization issues/ delays prior to receiving services and reschedule/ cancel if services not authorized; maintain authorization on file as needed going forward for additional services.
- Administers FHLC’s sliding fee discount program by obtaining necessary patient data and documentation to accurately calculate level for FHLC’s patients.
- Follows up on patient applications to ensure they are completed timely and accurately.
- Maintains strong working relationship with county resources and other organizations that review FHLC patient applications for assistance.
- Initiate appropriate forms for workers comp, disability, etc. as applicable and pass on the appropriate clinical providers to complete to ensure patients can receive their benefits in a timely manner.
- Ability to analyze and interpret information included in but not limited to sliding fee support application materials, IRS materials, credit reports, payer regulations, payer contracts etc.
- Handles all patient/family contact in a courteous, professional manner and consistently interacts with sensitivity to patients/their families and is responsive to individual needs.
- Ability to work collaboratively in a team-based approach with clinical and non-clinical staff, patients and patient’s families.
- Provides an active voice in team meetings for the purpose of improving services to patients and maximizing patient benefits.
- Demonstrates ability to interact professionally in a variety of patient situations and adjust accordingly depending on the situation presented at time of service.
- Must adhere to FHLC policies and procedures.
- Regular and Reliable Attendance.
- Performs other duties as assigned.
Family Health La Clinica is proud to be an Equal Opportunity Affirmative Action employer.