Treatment Navigator

UNION COMMUNITY CARE•North Cornwall Township, PA

12d•Onsite

About The Position

Treatment Navigators provide customer service and support patients through registration, scheduling, understanding treatment options and costs, insurance benefits, prior authorizations, and financial arrangements. They help patients understand and complete treatment plans, coordinate appointments with the Dental Care Team, and work to address barriers to care. The role also includes maintaining accurate patient records, verifying insurance information, collecting payments, processing documents, and communicating with patients, team members, and insurance companies. The posting also describes Treatment Navigator Coach and Treatment Navigator Lead duties. A Coach performs Treatment Navigator duties, supports workflow research and error resolution, maintains knowledge of insurance guidelines, trains navigators, and provides reception coverage at Union’s administrative building and coverage at sites. A Lead performs Treatment Navigator Lead duties, supervises Treatment Navigators, and works with the Directors of Billing and Dental to reduce revenue loss and improve department efficiency. The position requires participation in mandatory all-staff meetings, team meetings, and trainings. The job is located at South 9th St. in Lebanon, Pennsylvania.

Requirements

High school diploma or GED.
Excellent communication skills.
Familiarity with computer systems.
Excellent customer service and telephone skills.
Organizational skills.
Creative problem-solving skills.
Strong understanding of scheduling.
Ability to work well with others as a team player.
Compliance with HIPAA regulations.
Basic mathematics skills.
Ability to describe procedures in simple language.
English proficiency.

Nice To Haves

Bilingual ability.

Responsibilities

Welcome patients and visitors at all sites and help establish a positive care experience.
Answer patient calls professionally and provide telephone customer service and assistance.
Check patients in; ensure consents are current, accounts are current, and demographic information in the EHR is accurate.
Verify and maintain patient demographic information, insurance eligibility, and benefits, and collect copayments and balances.
Offer and apply the Sliding Fee Discount program as appropriate.
Prepare daily batch reports and reconcile the cash drawer according to registration closing procedures.
Import and scan paperwork and forms, label and route documents in Athena, and remove duplicate documents and cover sheets.
Schedule treatment appointments, reschedule missed appointments, and contact patients who have not completed treatment and/or payments.
Coordinate appointments with preauthorizations, BLEs, and treatment plans.
Complete preauthorizations and BLEs to the best of their ability and scan related documents into the EHR.
Coordinate with patients and the team to complete treatment-plan work within the authorized period and reschedule appointments as needed.
Ensure authorizations are in place before appointments and communicate with the team when appointment changes are needed.
Complete and communicate Good Faith Estimates and ensure payment before treatment.
Assist patients with financial arrangements and create payment plans consistent with Union Community Care guidelines.
Coordinate with the Dental Care Team and patients to address barriers to completing treatment plans.
Review dental benefits with patients as needed.
Research questions from team members, patients, and insurance companies and follow up with answers.
Run eligibility and benefits checks for patients with upcoming appointments two days out.
Contact patients and/or insurance companies to obtain updated information.
Perform other work-related duties as assigned.
Participate in mandatory all-staff meetings, team meetings, and trainings.
For the Coach role: research workflows with Treatment Navigators, assist with errors, maintain knowledge of insurance guidelines, educate and train Treatment Navigators, and provide coverage at sites and reception at Union’s administrative building.
For the Lead role: supervise Treatment Navigators and work with the Directors of Billing and Dental to address potential revenue loss and improve department efficiency.