This is a remote position.
Title: Care Navigator
Schedule: MondayFriday 10am to 6:30pm (with 30min unpaid break) Tucsoon AZ (1:00 AM to 9:30 AM Manila Time)
Reports to Clinical Administration Manager (Crisel)
The Care Navigator is assigned a small portfolio of clients and is responsible for their client experience. The Care Navigator should easily be able to build rapport with clients explain complex information in a simple way and work with other members of the team to get the most accurate information. This is a generalist position and specialists in each of these areas will train and guide decisionmaking and processes.
The tasks include:
Finance and Billing
* Updating client profiles to ensure they are accurate and up to date
* Checking insurance eligibility and benefits before each appointment
* Charging client invoices before appointments
* Monitoring timely completion of Provider notes for each appointment
* Sending insurance claims after each appointment
* Communicating with each client about their eligibility and benefits any changes and outstanding payments
Clinical
* Medication refills
* Prior authorizations
* Collaborating with other providers as needed for client care (ROIs scheduling support)
* Coordinating client referrals
* monitoring and tracking health measures
* ensuring annual labs for all clients are on file ordered and the provider is informed.
* ensuring Abnormal Involuntary Movement Scale is onfile for clients receiving antipsychotic medications and inform the provider for when these are next due
* ordering GenoMind testing
Administration
* Monitoring and responding to portal messages
* Assigning tasks to the provider and other team members as needed
* Following up with other team members to complete tasks for the client
* Monitoring client scheduling changes and ensuring clients are active in care
* Escalating any issues complex questions or tasks to our specialist team members
Requirements
Qualifications:
- Bachelor s degree in healthcare administration business or a related field (preferred).
- Minimum of 2 years of experience in reviewing and interpreting healthcare insurance policies.
- Strong understanding of healthcare benefits eligibility criteria and billing processes.
- Excellent communication skills both written and verbal with the ability to convey complex information in an understandable manner.
- Demonstrated problemsolving and critical thinking skills to address client issues effectively.
- Proficiency in billing software and relevant healthcare technology systems.
- Detailoriented with strong organizational skills and the ability to manage multiple priorities.
- Ability to work independently and collaboratively within a team environment.
Minimum of 2 years of experience in reviewing and interpreting healthcare insurance policies. Strong understanding of healthcare benefits, eligibility criteria, and billing processes. Excellent communication skills, both written and verbal, with the ability to convey complex information in an understandable manner. Demonstrated problem-solving and critical thinking skills to address client issues effectively. Proficiency in billing software and relevant healthcare technology systems. Detail-oriented with strong organizational skills and the ability to manage multiple priorities. Ability to work independently and collaboratively within a team environment.
Education
Bachelor s degree in healthcare administration, business, or a related field (preferred).