TRC Social Care Navigator

The Resource Center•Jamestown, NY

13d•Hybrid

About The Position

The TRC Social Care Navigator, also known as a Patient Access Representative/Navigator, plays a crucial role in providing customer service, screening, and navigation services to community members. This position involves empathetic and culturally competent outreach to identify social determinants of health, process referrals, and assist individuals in accessing necessary services. The role requires excellent communication and organizational skills to manage patient records, accounts, and administrative tasks, ensuring a smooth and efficient flow of operations within various integrated care settings.

Requirements

Exemplary customer service skills, including the ability to effectively deal with a variety of individuals including patients, providers, and other customers in a calm and professional manner.
Excellent telephone and verbal communication skills, as well as, effective interpersonal skills which promote cooperation and teamwork.
Demonstrated ability to effectively utilize multiple Electronic Health Record Systems, including but not limited to Anasazi, AllScripts, Dentrix, and Therap, in addition to computer software programs such as Microsoft Word.
Comprehensive knowledge of information gathering, processing, and filing systems.
Working knowledge of medical records management and office administration protocols.
Working knowledge of basic accounting and billing principles.
Flexibility, reliability, and ability to self-direct and self-initiate in order to meet deadlines.
Must be detail-oriented and possess strong organizational and time management skills, including the ability to effectively manage multiple priorities in a competent manner.
Typing ability sufficient to perform data entry.
Physical condition or reasonable accommodation(s) commensurate with the demands of the job.
Associate’s Degree in business, accounting, medical office, or related field plus one (1) year of demonstrated office experience (for Patient Access Representative).
Three (3) years of demonstrated office experience (for Patient Access Representative).
Associate’s Degree in business, accounting, medical office, or related field plus two (2) years of demonstrated office experience, a minimum of one (1) year of which was in a medical office, medical billing, or related capacity (for Patient Access Navigator).
Four (4) years of demonstrated office experience, a minimum of one (1) year of which was in a medical office, medical billing, or related capacity (for Patient Access Navigator).

Nice To Haves

Experience in medical office or medical billing strongly preferred (for Patient Access Representative).
Experience in medical office, registration, or medical billing strongly preferred (for Patient Access Representative).
Experience in medical office, medical billing, or related capacity (for Patient Access Navigator).
Candidates who are bilingual in English and Spanish preferred (for both roles).

Responsibilities

Provide empathetic and culturally competent screening for social determinants of health to community members telephonically, virtually and/or in-person.
Greet and assist individuals, visitors, and co-workers across a variety of disciplines and service environments in a prompt, courteous, and helpful manner.
Process screens and referral intake daily, including calls with potential program participants, documentation, and insurance/eligibility verification.
Answer telephone, screen calls, take messages, and provide information on behalf of individuals receiving services.
Optimize satisfaction and screening/navigation services when scheduling appointments in person and/or by telephone.
Conduct In-Home Assessments or telephonic assessments with community members.
Ensure patients' comfort by promptly addressing any questions and/or concerns.
Protect individual’s rights by maintaining confidentiality of personal and financial information, and comply with State, Federal, and Practice guidelines.
Investigate and resolve issues with accounts in a timely manner.
Aid individuals in distress by promptly and effectively responding to emergencies, by linking to, collaborating with, and/or referring for services.
Utilize a variety of EMR systems and IT platforms for the collection, compilation, and entry of information to ensure complete, accurate, and up-to-date records.
Responsible for documentation, medical and insurance referral records, protocols, and tracking, including maintenance of records, resolving individual referral issues, and securing prior authorizations for collaboration and treatment, as applicable.
Assist in responding to requests for Release of Information, including location and distribution of needed documents, in a timely manner and consistent with HIPAA guidelines.
Ensure the timely and accurate entry and/or filing of paperwork and electronic transfers of information received from outside sources into patient records.
At the time of each visit, verify all patient information, including but not limited to demographic and insurance information, patient contact, payer contact, registration interfaces, and automated processes.
Work with the Program Manager or designee to investigate and correct errors, research missing or incorrect account information, identify issues/trends with payers, and appropriately update account activity to facilitate the receipt of all reimbursement due.
Refer patients to appropriate personnel for billing issues, navigation, and care coordination as needed.
Perform clerical duties including typing, filing, and recordkeeping for services provided linked to Social Care Outcomes and program management.
Perform medical records maintenance and transcription duties as needed or assigned.
Ensure work areas are maintained in a neat and orderly manner.
Report any ideas and suggestions regarding processes, procedures, and protocols to management to facilitate the smooth and efficient operation of assigned service environment(s).
Perform all other duties as needed or assigned.
Provide off-site services as required by program and schedule.
Flex daily scheduled work hours per job task requirements to meet with individuals for job-related task completion within the standard work week.
Close the referral loop, including ensuring received referrals are attached to the patient record when complete.
Contact the patient or referring provider and/or referral source to check the status of overdue referrals or screenings.
Request records from referral source as applicable.
Determine if the patient needs additional assistance to keep or make an appointment if they have not made or attended one.
Assist with GAPS in care reports to achieve quality measures, as applicable.
Understand HEIDS quality measures and how they are achieved for quality performance.
Share the services that are offered at The Resource Center.
Attend community-based events to share program information with individuals, community partners, external agencies/providers to encourage referrals to operating programs.
Drop off materials to agencies or other providers to open referral networks and encourage collaborative care.
Attend local community meetings focused on Social Navigation and Screenings as directed by supervisor.
Complete internal referrals from department to department as applicable.
Ensure releases are completed at the time of referral and scanned into EMR programs.
Help guide patients through the Healthcare and Social Network systems.
Enroll patients in all services offered by The Resource Center in a timely manner, as applicable and requested.
Aggregate data collected for patient satisfaction surveys for additional reporting/QI projects.
Work to overcome obstacles that patients may have in receiving the care they require.
Promote client health, health education, and overall system wellness.
Welcome patients in a positive customer-focused manner.
Perform a wide variety of activities designed to facilitate and maintain the smooth, efficient flow of operations within a variety of integrated care settings including dental, behavioral health, primary care, health-related services, and care coordination.
Ensure the timely and accurate collection of all required pieces of information for patient’s demographics, insurance, and billing of all services in order to provide accurate information for the providers as well as obtain maximum reimbursement.
Maintain confidential healthcare information recorded in the Electronic Health Record (EHR) system in a timely manner in order to provide the most complete and accurate patient record possible and to facilitate optimum patient care.