Care Access Navigator

Roessel Joy

5d•Onsite

About The Position

The Care Access Navigator is responsible for preparing and obtaining documentation required for insurance prior authorizations, ensuring continuity of care, and helping clients maintain eligibility for services. This administrative role plays a key part in supporting high-quality healthcare delivery. Team members are cross-trained across multiple administrative functions, with daily responsibilities driven by the needs of the clients they serve.

Requirements

2+ years of experience processing high volumes of records, preferably in a healthcare setting.
2+ years of experience using Microsoft Office Suite.
Excellent organizational, problem-solving, customer service, and communication skills.

Nice To Haves

Experience with platforms such as HubSpot, Salesforce, Optum, WellSky, RingCentral, or similar systems is preferred.

Responsibilities

Develop a strong understanding of the organization's programs and operational workflows.
Request, obtain, and maintain medical documentation from healthcare providers, including progress notes, imaging reports, and other clinical records.
Review and compile documentation from internal and external sources to ensure continued program eligibility.
Verify insurance coverage and submit authorization requests according to payer requirements.
Communicate with healthcare providers, insurance companies, and multidisciplinary care teams regarding documentation and authorization needs.
Maintain accurate client records and update patient, provider, and insurance information.
Prioritize and expedite requests while providing exceptional customer service.
Process and triage incoming faxes, directing them to the appropriate team member or patient record.
Maintain detailed documentation of client interactions and workflows.
Provide general administrative support, including answering phones, managing email correspondence, scanning, filing, photocopying, and faxing.
Escalate client concerns or workflow issues to management when appropriate.
Maintain strict confidentiality of protected health information (HIPAA compliance).
Represent the organization professionally and uphold its mission and values.
Demonstrate compassion and respect for the diverse communities served.
Mentor and support fellow team members as needed.
Assist with additional administrative projects and responsibilities as assigned.