Patient Access Coordinator

1 day ago

Gloucester, Massachusetts, United States North Shore Community Health Inc Full time
Job Title: Patient Access Navigator

North Shore Community Health Inc is seeking a dedicated and detail-oriented Patient Access Navigator to join our team. The primary purpose of this role is to assist patients with navigating the financial complexities related to paying for healthcare.

Key Responsibilities:
  • Provide navigational services for MassHealth and ConnectorCare plans, assisting patients with enrollment, re-enrollment, and insurance management.
  • Act as a delegate for clients when necessary to overcome barriers to MassHealth or ConnectorCare enrollment.
  • Assist patients with North Shore's internal financial assistance programs, including sliding fee scales and payment plans.
  • Manage work queues and in-baskets within NSCH's EHR to identify referrals to Patient Access Navigator services.
  • Work in a flexible environment to balance pre-scheduled appointments, walk-ins, and ad-hoc needs, ensuring high-quality customer service for NSCH patients.
  • Establish and maintain relationships with community organizations, organizing educational and enrollment events.
  • Attend occasional evening and weekend community events, such as health fairs and festivals, to educate and enroll consumers in insurance programs on-site.
  • Manage personal documents required for insurance enrollment professionally and in compliance with policies, even in non-traditional settings.
  • Utilize information from NSCH's EHR and MassHealth to identify and resolve eligibility and coverage issues, maintaining continuity of care for patients.
  • Perform outreach aimed at boosting MassHealth C3 enrollment, including engaging uninsured and underinsured patients, scheduling newly enrolled patients assigned to North Shore, and navigating changes to non-C3 ACO MassHealth patients seeking routine care at an NSCH health center.
  • Ensure that patients participating in plans with which North Shore maintains a value-based agreement are able to fully benefit from Value-Based care, are properly enrolled and engaged in care.
  • Fax and upload documents to the MassHealth portal as provided by patients.
  • Track personal metrics related to outreach, enrollment, and engagement.
  • Collaborate with other NSCH Navigators to ensure comprehensive patient care.
  • Attend all required state and federal enrollment training sessions.
  • Maintain certification as a Certified Application Counselor (CAC).
Requirements:
  • High school diploma or equivalent
  • At least one year of experience in non-profit or healthcare work, preferably in assisting community members in program enrollment.
  • Third party billing or medical reception experience strongly preferred
  • Willingness to receive CAC certification within 3 months of employment
  • Working knowledge of insurances – specifically MassHealth – strongly preferred.
  • Fluency in English AND either Spanish or Portuguese
  • Demonstrated strong communication skills with individuals and/or groups
  • Proficiency in Microsoft Office applications (Excel, Word, PowerPoint)
  • Experience working in Epic is strongly preferred
  • Valid MA driver's license
  • Maintains strict adherence to the NSCH Confidentiality policy
  • Incorporates NSCHI values, principles and mission statement into daily activities
  • Complies with all NSCHI personnel policies and procedures
  • Strong analytical, problem solving, planning and prioritization skills
  • Self-motivated and self-directed to work within a team and/or work independently
  • Extremely detail-oriented in both verifying own work as well as the work of others

North Shore Community Health Inc is an equal employment opportunity employer. We are committed to building healthy communities by providing exceptional care to all. Our mission is to foster a supportive and rewarding environment that empowers our team members to provide exceptional care to our communities.

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