Patient Navigator (Immersiv)

Downing Capital Group

19h

About The Position

Immersiv is a new medical infusion clinic company that is designed to enhance both the providers’ and patients’ experiences as they navigate through the healthcare system. Healthcare today is disjointed, confusing, and transactional. We see the opportunity to treat our infusion clinics as something more than just a place for patients to receive their medication. Immersiv will also offer access to vaccines, outcomes assessments, and so much more. In addition, we empower our clinicians to promote conversations about patients’ concerns, action on prescriptive opportunities, and provide elite medical care overall. About This Role The Patient Navigator works closely with referring providers, patients, and payors to on-board patients to service as timely and seamlessly as possible. They help ensure patients are qualified for service and coordinate initiation and on-going treatment with all parties involved.

Requirements

High school diploma or equivalent
Minimum of two years’ experience in patient intake, revenue operations, billing, insurance case management or clinical setting in a healthcare facility
Must possess a strong work ethic and team mentality, with excellent interpersonal skills for interacting with patients, providers, and coworkers.

Nice To Haves

Prior experience with ambulatory infusion center software or EMR
Prior experience within a specialty pharmacy setting

Responsibilities

Process new patient referrals, entering patient demographic, payor, and billing information timely and accurately.
Communicate with various payors, referral sources, patients and representatives regarding: Documentation to support medical necessity, payor coverage, and appeals Financial assistance eligibility and enrollment Payment plans for patient financial responsibility Pharmaceutical/Manufacturer hub services and enrollment
Verify eligibility and benefits accurately and in a timely manner in accordance with company policies.
Obtain initial authorizations following company policy and maintain active authorization on all patients as appropriate.
Ensure thorough documentation of all coordination and all necessary documentation for billing is in the patient’s record.
Schedule patient visits according to established procedures.
Obtain patient orders, office visit notes, diagnostic and lab results from outside provider offices.
Comply with payor medical policy, FDA guidelines, and CMS billing and coding guidelines.
Process all required paperwork according to established procedures while ensuring data integrity.
Update knowledge and skills by attending in-service programs throughout the year.
Answer telephone calls and emails in a professional and timely manner.
Other related duties as assigned.