Patient Navigator III

BMC Software•City of Schenectady, NY

2d•$25 - $31

About The Position

The Patient Navigator III supports the Geriatrics clinical practice, with a focus on billing and managed care functions, including charge entry, billing edits, charge reconciliations, responding to billing inquiries, communicating with insurance carriers, and investigating billing discrepancies. The role may also support front-end customer service, patient registration, insurance and coverage verification, and other administrative needs. The position coordinates patient access activities, including customer service, registration, insurance verification, appointment scheduling, billing and managed care, and administrative support for the department. It also provides physician and departmental support, such as calendar management, credentialing documentation, and handling calls and correspondence. The position adheres to BMC’s RESPECT behavioral standards.

Requirements

High school diploma or GED plus at least 3 years of relevant experience; alternatively, a bachelor's degree or an associate degree plus 1 year of relevant experience.
Excellent oral and written English communication and interpersonal skills to interact courteously and with a patient-focused manner with internal and external contacts.
Demonstrated customer service skills, including appropriate judgment, independent thinking, and creativity in resolving customer issues.
Ability to maintain strict confidentiality of personal and health-sensitive information.
Ability to handle challenging situations effectively and balance multiple priorities.
Strong computer skills and knowledge of Microsoft Office applications (Word, Excel, Access, and PowerPoint) and web/internet.
Experience with standard hospital registration and billing systems, or ability to learn such systems.

Nice To Haves

Experience with medical billing or a similar setting.

Responsibilities

Perform charge entry, batch controls, billing (TES) edits, hold bill edits, and charge reconciliations.
Support billing and managed care functions, including responding to billing inquiries, corresponding with insurance carriers, and investigating billing discrepancies.
Create and edit department documents and presentations using word processing, spreadsheets, and presentation software.
Provide physician and departmental support, including managing physician and manager calendars, scheduling administrative appointments, answering departmental calls, and handling credentialing documents.
Provide reception and customer service.
Create or verify the Master Patient Index (MPI), registration demographics, and visit management.
Schedule appointments, including consults, tests, in-office procedures, follow-up visits, and cross-booking interpreters, social services, and radiology.
Verify insurance and coverage, collect co-payments, and review and correct registration and insurance edits.
Coordinate pre-authorizations and referrals, reconcile referrals, and manage referral work lists.
Handle phones and mail; complete forms; file, photocopy, and fax documents; and prepare letters and reports.
Adhere to BMC’s RESPECT behavioral standards.