Patient Navigator - Orthopedics and Sports Medicine

Job description

The Patient Navigator 2collaboratively supports and guides an identified patient population through the process of receiving care within a designated specialty. Coordinates the flow of patient care between the practice and other healthcare providers across the continuum of care. Performs various administrative functions, including registration, scheduling, billing, and precertification/authorizations, while conveying a positive image of the clinic and providing excellent customer service.
• Patient Coordination
• Schedules appointments within clinic according to established procedures.
• Facilitates coordination among all providers and hospital for patient care. Schedules pre-operative testing, lab workups, assessments, clearances, etc. and works with patient to assure completion.
• Informs patients about the care process including workup, post-operative period and follow-up, to facilitate efficient and effective care. Enables informed patient decision-making by providing knowledge and education on the bariatric process and assesses patient understanding; works interactively with all providers involved in the patients care to ensure comprehension.
• Gathers all tests results and presents to the physician for review. Contacts the patient with any abnormal tests results for continued testing if needed.
• Schedules patients follow up appointments after procedure is completed, both within clinic and with other providers as needed.
• Takes patient calls, assesses situation and determines necessity and urgency for appointment based on status; communicates with physician and/or other providers as needed to provide best care.
• Patient Accounts and Access
• Serves as resource and liaison between patient, clinic and insurance companies to facilitate understanding of payment options.
• Requests records from external sources as needed. Completes and submits all paperwork effectively to minimize delays and/or denials, while adhering to all applicable regulations.
• Performs insurance verification/eligibility; secures pre-authorizations and/or referrals effectively.
• Estimates cost of service and the patients' responsibility, analyzes and documents the patients' account history and assists patients with financial assistance and referrals within scope of practice.
• Collects payments from patient, insurance company, or other sources as appropriate. Coordinates appeals process as necessary or appropriate.
• Other duties as assigned.
• Facilitates support groups as needed or assigned.
• Assists in the development and maintenance of educational programs to practice team members, medical staff, community or others to further the provision of exceptional care.
• Implements policies and practices, and provides input into performance improvement ideas, particular to the scope of care provided for this specific patient population. Identifies problems and facilities solutions; communicates findings and suggestions.
• Acknowledges patient and family values in all aspects of their care and models behaviors to other team members both within and outside of practice.
• Monitors the expenditures of the practice. Maintains expenditures within budget guidelines to include volume.
• Obtains and maintains high level of information and expertise regarding specific patient population and procedural specialty.

Experience - 3 years administrative experience in a physician practice providing a designated procedural specialty, including registration, scheduling, insurance, and billing
Education - High School diploma