Prior Auth Treatment Navigator

JOB SUMMARY

The Treatment Navigator’s responsibility is to clearly explain treatment plan options and related costs to patients. Treatment Navigators ensure patients understand their treatment plan, insurance benefits (including prior authorizations), review and discuss fees with patient along with assisting with financial arrangements and coordination of appointments.

SPECIFIC JOB DUTIES

• Schedule patient’s treatment appointments, reschedule patients that miss their appointments and call patients that have not completed treatment and/or payments (HRPREPay).
• Coordinates patient appointments to align with Preauthorization/BLE’S and Treatment Plans.
• Communicates with the team and patient to ensure treatment plan work is completed within the authorized period.
• Communicates with the team and patients when appointments need rescheduling to ensure work is complete within authorized period.
• Ensures that all authorizations are in place prior to patient appointment and communicates with the team if appointment changes need to occur to ensure preauthorization is in place.
• Completes and communicates with patient the Good Faith Estimate and ensures payment prior to treatment.
• Assist patient with financial arrangements.
• Fully understands and can apply the Sliding Fee Discount Policy and Procedures.
• Ensure patients understand their treatment plan and coordinates with the Dental Care Team and patient to address any barriers to the patient completing the treatment plan.
• Reviews Dental Benefits with patients as needed.
• Coordinates with Dental PAS to ensure accurate patient information is documented in dental records.
• Fields questions from team members, patients and insurance companies, researches answers, and then follows up.
• Maintains patient demographic information, including insurance eligibility and benefit verification.
• Creates payment plans with patients that follow the guidelines established by Union Community Care.
• Run Eligibility on patients with upcoming appointments
• Receptionist for Union’s Admin Building
• Performs other work-related duties as assigned.

JOB REQUIREMENTS

To perform this job successfully, an individual must be able to perform all duties satisfactorily. The requirements listed below are representative of knowledge, skill, and/or ability required.

• Ability to describe procedures in simple language
• Excellent communication skills
• Familiarity with computer systems
• Customer service skills
• Excellent telephone skills
• Organizational skills
• Creative problem- solving skills
• Keen understanding of scheduling
• Ability to work independently
• Compliance with HIPPA regulations
• Basic mathematic skills
• Bilingual preferred
• Ability to work well with others

ESSENTIAL FUNCTIONS

To fulfill the requirements of this position, duties 1-17 are considered essential functions of the job.

ORGANIZATIONAL INVOLVEMENT

This position is required to participate in mandatory all staff meetings, team meetings and trainings.

Job Type: Full-time

Expected hours: 40 per week

Benefits:

• 403(b)
• 403(b) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Health savings account
• Paid time off
• Tuition reimbursement
• Vision insurance

Work Location: In person