Treatment Navigator

Our Mission, Vision, & Model of Care

At Union Community Care, our purpose is at the forefront of all that we do: we stand for whole health to help you live your fullest life.

We envision vibrant and healthy communities supported by inclusive healthcare that embraces each member’s unique culture, needs, and values, and emboldens them to make healthful choices that fuel their well-being and the well-being of others.

We believe in whole health. This means we address and heal disease but equally important, we work at the causes of the causes, the social ills that must be addressed to achieve true equity.

We listen, learn, and embrace the complex lives and unique strengths of our patients, and we work hard to break down all barriers to care. This means we look through a grassroots lens. We connect with our communities because we are our communities. Each of us is a neighbor, a friend, a family member, and together, we are a trusted community health center.

JOB SUMMARY

The Treatment Navigator’s are responsible for delivery of excellent customer service, accurately and efficiently performing patient registration, appointment scheduling and clearly explain treatment plan options and related costs to patients. Treatment Navigators ensure patients understand their treatment plan, insurance benefits (including prior authorizations), review and discuss fees with patient along with assisting with financial arrangements and coordination of appointments.

SPECIFIC JOB DUTIES

Ensures all patients and visitors feel warmly welcomed at all sites. Set the tone for a superb care experience.

Provides superior telephone customer service for patients seeking access or assistance by answering phones professionally and knowledgeably.

Performs patient check-in ensuring that all consents are current, patient account is current, and all demographic data is up to date and accurate in the EHR.

Verifies and maintains all patient demographic, insurance eligibility and benefits and collects all copays/balances

Offers Sliding Fee Discount to all patients, understands and applies the program as needed

Prepares daily batch report and reconciles cash drawer using the registration closing procedure

Preforms daily importing and scanning of necessary paperwork and forms, labels and routes documents to the appropriate recipient in Athena, deletes duplicate documents and cover sheets

Schedules all patient treatment appointments, reschedules patients that miss their appointments and call patients that have not completed treatment and/or payments (HRPREPAY).

Coordinates patient appointments to align with Preauthorization/BLE’S and Treatment Plans.

Ensures that all Preauthorizations and BLEs are completed to the best of their ability and scans all related documents into the HER.

Communicates with the team and patient to ensure treatment plan work is completed within the authorized period.

Communicates with the team and patients when appointments need rescheduling to ensure work is complete within authorized period.

Ensures that all authorizations are in place prior to patient appointment and communicates with the team if appointment changes need to occur to ensure preauthorization is in place.

Completes and communicates with patient the Good Faith Estimate and ensures payment prior to treatment.

Assist patient with financial arrangements.

Ensure patients understand their treatment plan and coordinates with the Dental Care Team and patient to address any barriers to the patient completing the treatment plan.

Reviews Dental Benefits with patients as needed.

Fields questions from team members, patients and insurance companies, research answers, and then follows up.

Creates payment plans with patients that follow the guidelines established by Union Community Care.

Run Eligibility and Benefits on patients with upcoming appointments (2 days out)

Contacts patients and/or insurance companies for updated information

Performs other work-related duties as assigned.

SPECIFIC JOB DUTIES- Treatment Navigator Coach

Performs all duties of Treatment Navigator

Works with Treatment Navigators to research appropriate workflows

Assists with errors

Keeps ongoing knowledge of current Insurance guidelines and educates Treatment Navigators

Responsible for Training of Treatment Navigators

Floats to sites to cover call offs and PTO

Receptionist for Union’s Admin Building

SPECIFIC JOB DUTIES- Treatment Navigator Lead

Performs all duties of Treatment Navigator Lead

Works with Director of Billing to maximize potential revenue loss based on our unique services and providers

Works with Director of Billing and Director of Dental to maximize department efficiency

Responsible for Supervision of Treatment Navigators

JOB REQUIREMENTS

To perform this job successfully, an individual must be able to perform all duties satisfactorily. The requirements listed below are representative of knowledge, skill, and/or ability required.

High School Diploma or G.E.D.

Excellent communication skills

Familiarity with computer systems

Excellent Customer service skills

Excellent telephone skills

Organizational skills

Creative problem- solving skills

Keen understanding of scheduling

Strong team player & Ability to work well with others

Compliance with HIPPA regulations

Basic mathematic skills

Ability to describe procedures in simple language

English proficiency required

Bilingual preferred

ESSENTIAL FUNCTIONS

To fulfill the requirements of this position, duties 1-22 are considered essential functions of the job.

ORGANIZATIONAL INVOLVEMENT

This position is required to participate in mandatory all staff meetings, team meetings and trainings.