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Patient Navigator

4 months ago

Warwick, United States Ortho Rhode Island Full time
Job DescriptionJob Description

Ortho Rhode Island is a world-class group of talented providers and professionals, all working together to offer value and quality in everything we do. Each Ortho Rhode Island team member is dedicated to thinking like a patient, and to offering the best experience in our industry, driven by our core values: delivering on our word, respecting each other, innovating in orthopedics, valuing every individual, and engaging our community.

The Vision of Patient Navigator program is the essential link in providing a team-based approach to patient care and an exceptional patient experience. The Patient Navigator will emphasize highly personalized care and help patients surpass barriers to healthcare by improving the patient/provider relationship.

Duties and Responsibilities include but are not limited to:

  1. Welcomes patients by greeting them, in person or on the telephone, answering or referring to inquiries.
  2. Prepares patients for the health care visit by accompanying them to exam room; providing exam gowns; arranging examining room instruments, supplies, and equipment to create an exceptional patient experience.
  3. Preparing patient charts prior to patient arrival
  4. Knowledgeable of check in software
  5. Assist providers in the treatment of patients by obtaining histories and vitals, preparing injections, setting up sterile fields, suture removal, dressing changes.
  6. Verifying patient’s medical record is complete and accurate for medical coding purposes.
  7. Triage patient calls and physician messages
  8. Process and fulfill physician approved prescription requests.
  9. Obtain authorizations for prescriptions.
  10. Maintain exams rooms with adequate medical supplies and sterilization as required.
  11. Completing forms such as (but not limited to): TDI/FMLA and Work Notes
  12. Scheduling follow up appointments, initial therapy visits, and MRI appointments.
  13. Obtain prior authorizations as needed for advanced imaging studies and specialty injections as assigned.
  14. Advise patients on any co-payment or co-insurance prior to in office procedures.
  15. Update patient of authorization status and confirm receipt of specialty injection or imaging study being sent to facilities outside of ORI.
  16. Send referrals to specialists and pain centers as ordered by the physician.
  17. Remain accountable and follow through on all commitments made to patients.
  18. Compliance with HIPAA and OSHA regulations
  19. Other duties may be assigned as necessary.

Performance Requirements:

Knowledge:

  1. Excellent computer skills
  2. EMR Systems
  3. Practice Management System
  4. Microsoft Suite (including Outlook, Word, Excel, Calendar)
  5. Phone Software
  6. Check-In Software
  7. Basic knowledge of insurance plans and referral requirements
  8. Knowledge of estimated co-payment and co-insurance
  9. Navigating Insurance Authorization websites
  10. Clinical knowledge, injections, DME, and Casting
  11. General understanding of processing legal forms (i.e. TDI, FMLA, etc.)
  12. Effectively communicate tasks or projects to team members
  13. Ability to collaborate with supervisory teams and administrators on projects or assigned tasks.

Skills:

  1. Familiarity and follow through with all HIPAA compliance.
  2. Attention to detail.
  3. Self-motivated, showing initiative to tackle important issues, problems, and tasks.

Abilities:

  1. Embracing ORI’s mission and vision through friendly and patient-oriented service
  2. Demonstrate excellent teamwork, organizational, and communication skills.
  3. Adheres to processes, while looking for opportunities for innovation and improvement
  4. Critical thinking skills and deliberate decision making.
  5. Able to work at a fast pace, while demonstrating patience with patients
  6. Adheres to processes, while looking for opportunities for innovation and improvement
  7. Assertive

Work Environment:

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, and filing cabinets.

Physical Demands:

  • Requires mobility, frequent walking, standing, and sitting, some bending, stooping, and stretching and periodic lifting of up to 50 lbs.
  • While performing the duties of this job, the employee is regularly required to converse and hear.
  • Requires normal (corrected) vision.
  • Requires coordination and manual dexterity sufficient to operate office equipment.

Position Type and Expected Hours of Work:

This is a full-time, Monday through Friday position. Shifts will be assigned in advance but may vary depending on the Company Schedule. The hours will typically range from 7:00 am to 5:30 pm and may be subject to change based upon access requirements at locations.

Travel:
No overnight travel is expected for this position. There may be occasional local day travel to Company Divisions.

Required Education and Experience

  1. High School Graduate or equivalent
  2. Formal training as a medical assistant or certification as a medical assistant (preferred).
  3. Any combination of education, training, and experience that demonstrates the ability to perform the duties of the position.
  4. Experience with Electronic Medical Records