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Job Profile Name Bariatric Patient Navigator - Full Time
Salary
0
Job Description
Department
VH VPE META BARI - WINC - 159330Worker Sub Type
RegularWork Shift
Pay Grade
109Job Description
The Advanced Bariatric Patient Navigator coordinates the front-end of the revenue cycle by processing pre-registration, registration, demographic and financial verification activities for patient appointments.Responsibilities and Duties
Responsible for the review of patient insurance payor/plans, verification of eligibility through Epic’s RTE platform or third-party websites, and accurate documentation of eligibility in the patient’s medical record. Manages patients through pipeline to ensure they move through the process as efficiently as possible. The pipeline status is reported to Bariatric Coordinator and Office Manager on a monthly basis. Acts as point-of-contact for all non-clinical patient questions and concerns and manages the assignment of patients without a surgeon preference. Coordinates verification of insurance benefits for all patients within 48 hours of seminar attendance. Calls patients within 72 hours of the seminar to communicate the results of benefits verification and to schedule an initial consultation appointment. Provides counseling to patients with exclusions on self-pay and financing options. Meets with each patient at the end of their initial consultation appointment to discuss insurance and clinical requirements and the process to surgery. Responsible for tracking patient status information and entering all insurance and clinical requirements in tracking tool. Responsible to develop expertise on requirements for authorization for each insurance company with which the program works, including diet history, medically supervised weight loss, and psychological evaluation requirements. Tracks incoming clearances in tracking tool to monitor patient progress in meeting insurance and clinical requirements, follow-up with patients monthly to check status of requirements fulfillment to keep them engaged with program and contact external providers to obtain missing paperwork on behalf of patient. Collaborates with clinical staff and providers to ensure patients have completed all requirements prior to surgery, obtain authorization for surgery according to insurance specifications and guidelines, contributes to proactive follow-up with insurance companies to check status of submissions and call patients upon insurance approval to schedule pre-op class, pre-op appointment, surgery date, and first post-op appointment.
Education
High School Diploma or GED required
Associates required*
* Will accept 5 years of medical clinic experience in lieu of Associates degree
Experience
One year customer service related experience required, Experience working in the Bariatric field preferred Experience working in a medical clinic setting preferred One to three years working with insurance companies and obtaining authorizations preferred Experience with ICD and CPT coding preferred Knowledge of basic keyboarding (computer or typewriter) helpful. One (1) year minimum experience preferred.
Qualifications
Strong computer skills required
Ability to demonstrate excellent judgment required
Excellent verbal and written communication skills required
Ability to accurately document patient status required
Ability to manage multi tasks/assignments simultaneously required
Ability to function as team member and promote teamwork required
Knowledge and understanding of insurance benefits and verification of benefits required
FLSA Classification
Non-exempt
Physical Demands
6 A Customer Service
Benefits
At Valley Health, we believe everyone is a caregiver, and our goal is to create an environment where our caregivers thrive physically, financially, and emotionally. In addition to a competitive salary, our most popular benefits for full-time employees include:
- A Zero-Deductible Health Plan
- Dental and vision insurance
- Generous Paid Time Off
- Tuition Assistance
- Retirement Savings Match
- A Robust Employee Assistance Program to help with many aspects of emotional wellbeing
- Membership to Healthy U: An Incentive-Based Wellness Program
Valley Health also offers a health savings account & flexible spending account for childcare, life insurance, short-term and long-term disability, and professional development. In addition, several perks come with working for the largest employer in the region, such as discounts to on-campus dining, and more.
To see the full scale of what we offer, visit valleyhealthbenefits.com.
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