Health Center Navigator

Position Overview

Essential Functions

• Supports and adheres to the Organization's Mission, Vision, and Values.
• Successfully completes required Health Insurance Navigator training and certification and maintains certification as required.
• Complies with applicable Navigator requirements and maintains current knowledge of health insurance enrollment policies and procedures.
• Assists uninsured and underinsured patients in identifying and obtaining available health insurance coverage, including Medicaid, Marketplace coverage, and other applicable programs.
• Assists in obtaining the Family Health Center sliding fee scale discount by collecting and verifying documentation required to determine eligibility based on Federal Poverty Level guidelines.
• Assists with Medicaid applications, including presumptive eligibility and full Medicaid enrollment, and provides education regarding available Marketplace coverage options.
• Coordinates with Registration and Billing staff to ensure newly obtained insurance coverage is accurately documented in the Electronic Health Record (EHR).
• Monitors self-pay patients and follows up on potential changes in insurance coverage to support timely and accurate billing.
• Assists with scheduling appointments and connecting with appropriate providers and services based on identified needs.
• Identifies and develops relationships with community organizations and agencies to support patient enrollment, outreach, education, and access to resources.
• Connects patients/clients with community resources and provides follow-up to assist with identified social and economic needs.
• Supports in navigating barriers to care, including access to insurance, healthcare services, and community resources.
• Maintains accurate and timely documentation of patient/client interactions, applications, services, and follow-up activities in the EHR.
• Protects patient and personally identifiable information and maintains confidentiality in accordance with HIPAA and organizational policies.
• Participates in required meetings, training, and continuing education activities.
• Performs other duties as assigned.

Work-Related Experience

• Experience working with health insurance enrollment, patient assistance, or community resources preferred.
• Experience working with diverse populations and individuals experiencing barriers to healthcare access preferred.
• Experience in a healthcare, community service, or customer service setting preferred.

Physical Demands and Work Environment

• Strong attention to detail and accuracy when handling patient and insurance information.
• Ability to understand and apply health insurance requirements, policies, and procedures.
• Strong organizational and problem-solving skills with the ability to prioritize and manage multiple responsibilities.
• Ability to communicate effectively and professionally with patients, staff, insurance representatives, and community partners.
• Ability to maintain confidentiality and exercise sound judgment when handling sensitive information.

• Ability to perform repetitive motions, including typing for EHR documentation.
• Able to perform essential job functions effectively.
• Sufficient visual and hearing acuity to complete work accurately.
• Prolonged sitting at a desk with frequent computer use.
• Manual dexterity is necessary to operate computers and other office equipment.

• Clean, well-lit, ventilated office environment.

Education, Certification, and Licensure

skills

• Strong verbal and written communication skills.
• Effective customer service and interpersonal skills.
• Ability to explain complex information in an understandable manner.
• Strong organizational and time management skills.
• Ability to work independently and as part of a team.
• Ability to prioritize multiple tasks and meet deadlines.
• Proficient computer and data entry skills.
• Ability to maintain confidentiality and exercise sound judgment.
• Ability to build positive relationships with patients, staff, and community partners.