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Care Coordinator
2 months ago
Upward Health is seeking a highly skilled and compassionate Care Navigator to join our multidisciplinary team. As a Care Navigator, you will be the single point of contact for our patients, ensuring a seamless experience and providing extensive support and assistance.
Key Responsibilities- Single Point of Contact
- Coordinate with providers and Care Team members to provide ongoing support and communication to our patients and ensure a smooth continuum of care
- Monitor patient hospitalizations and follow up as necessary with Care Team staff
- Provide patients with educational materials and execute correspondence to primary care physicians and specialists for new patient enrollments/appointments
- Collect, verify, & coordinate clinical and administrative information (e.g., Hospitalizations, Insurance)
- Patient Registration
- Perform outbound calls to patients to understand their clinical needs and connect them with appropriate resources
- Collect, enter, and/or confirm patient demographic, health, insurance, and payment information in EHR and related systems
- Help patients register for and access the EHR patient portal
- Explain Upward Health's payment policy to patient
- Facilitate completion of new patient forms
- Insurance Verification and Authorization Fulfillment
- Verify patient insurance information using insurance card and payers' portals
- Contact payers for out-of-network inquires and to determine coverage policies
- Identify patient cost-sharing amount and enter in EHR and related systems
- Identify and complete prior authorizations for services and medications
- Monitor insurance changes and identify/research established patients who lose eligibility
- Scheduling & Check-in
- Ensure that patient appointments with Upward Health providers are scheduled promptly and efficiently
- Manage patient appointment cancelation and rescheduling as needed
- Ensure patient missed appointments are rescheduled and communicated to the physician/clinician, patient, and members of the Care Team
- Maintain system of notifications sent to patients about scheduled appointments
- Attach any pre-visit paperwork to the patient's EHR chart
- Ensure completion of as-needed patient clinical and administrative forms ahead of visits
- Contact patient in advance of or at beginning of appointment to complete check-in and:
- Confirm demographic information
- Confirm patient insurance eligibility
- Review patient account balance and any co-payments due
- Collect payment information from patients, including processing credit card payments for patient cost-sharing amounts
- Notify patients of necessary future appointment details
- Provide minor technical assistance to ensure that patients can access virtual visits
- Follow Up Support from Provider Visits
- Assistant the providers delivering care as it relates to pre and post visit documentation, following up on orders, faxes, and labs, and ensuring smooth experience for patient and provider
- Perform outbound calls to providers to make appointment for patients or follow up on care
- Follow up with patients to ensure their needs are met and schedule future wellness discussions
- Expedite follow up to further coordinate next steps as to the patient response, scheduling needs and insurance coordination
- Various Administrative Support and Other Duties
- Lead the answering of the phone and responding to the fax machine for patient inquires
- Answer inbound calls from patients, providers, and Upward Health resources as necessary
- Collaborate with Finance colleagues on patient billing issues
- Handle medical record requests
- Manage the incoming queue of patient referrals
- Prepare reports and documents as needed or requested, ensures Care Team is following proper documentation protocols at the direction of the Manager
- Attend regular team meetings and participate in clinical rounds
- Maintain patient, provider, & payer contact & referral Information
- Other duties as assigned
- 3+ years at an outpatient healthcare practice serving as a patient representative or similar experience
- High school graduate or GED required
- Prior experience in health insurance and medical terminology is preferred
- Knowledge of community resources in applicable geographic area
- Able to maintain clear professional boundaries with members and coworkers
- Cultural competency – able to work with diverse groups of community members
- Highly technologically savvy
- Report development from clinical and non-clinical systems
- Ability to assist with development and distribution of educational materials
Upward Health is proud to be an equal opportunity/affirmative action employer. We are committed to attracting, retaining, and maximizing the performance of a diverse and inclusive workforce.
This job description is a general outline of duties performed and is not to be misconstrued as encompassing all duties performed within the position.