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Patient Navigator (Immersiv)

Roles & Responsibilities

  • High school diploma or equivalent
  • Minimum of two years’ experience in patient intake, revenue operations, billing, insurance case management, or clinical setting in a healthcare facility
  • Must possess a strong work ethic and team mentality, with excellent interpersonal skills for interacting with patients, providers, and coworkers
  • Preferred experience with ambulatory infusion center software or EMR and/or prior experience within a specialty pharmacy setting

Requirements:

  • Process new patient referrals, entering patient demographics, payor, and billing information timely and accurately; verify eligibility and benefits per policy
  • Communicate with payors, referral sources, patients and representatives regarding medical necessity documentation, payor coverage, appeals, financial assistance eligibility/enrollment, and payment plans
  • Obtain initial authorizations and maintain active authorizations; ensure complete coordination documentation and all required billing documentation in the patient record
  • Schedule patient visits, obtain orders, office notes, diagnostics and lab results from outside providers; comply with payor policies, FDA guidelines, and CMS billing and coding guidelines; process paperwork and maintain data integrity

Job description

Patient Navigator

Who We Are

Immersiv is a new medical infusion clinic company that is designed to enhance both the providers’ and patients’ experiences as they navigate through the healthcare system.  Healthcare today is disjointed, confusing, and transactional.  We see the opportunity to treat our infusion clinics as something more than just a place for patients to receive their medication. Immersiv will also offer access to vaccines, outcomes assessments, and so much more.  In addition, we empower our clinicians to promote conversations about patients’ concerns, action on prescriptive opportunities, and provide elite medical care overall.

About This Role

The Patient Navigator works closely with referring providers, patients, and payors to on-board patients to service as timely and seamlessly as possible. They help ensure patients are qualified for service and coordinate initiation and on-going treatment with all parties involved.  

What You’ll Do

  • Process new patient referrals, entering patient demographic, payor, and billing information timely and accurately.
  • Communicate with various payors, referral sources, patients and representatives regarding:
    • Documentation to support medical necessity, payor coverage, and appeals
    • Financial assistance eligibility and enrollment
    • Payment plans for patient financial responsibility
    • Pharmaceutical/Manufacturer hub services and enrollment
  • Verify eligibility and benefits accurately and in a timely manner in accordance with company policies.
  • Obtain initial authorizations following company policy and maintain active authorization on all patients as appropriate.
  • Ensure thorough documentation of all coordination and all necessary documentation for billing is in the patient’s record.
  • Schedule patient visits according to established procedures.
  • Obtain patient orders, office visit notes, diagnostic and lab results from outside provider offices.
  • Comply with payor medical policy, FDA guidelines, and CMS billing and coding guidelines. 
  • Process all required paperwork according to established procedures while ensuring data integrity.
  • Update knowledge and skills by attending in-service programs throughout the year.
  • Answer telephone calls and emails in a professional and timely manner.
  • Other related duties as assigned.

 

Requirements

  • High school diploma or equivalent
  • Minimum of two years’ experience in patient intake, revenue operations, billing, insurance case management or clinical setting in a healthcare facility
  • Must possess a strong work ethic and team mentality, with excellent interpersonal skills for interacting with patients, providers, and coworkers.

Preferred Experiences

  • Prior experience with ambulatory infusion center software or EMR
  • Prior experience within a specialty pharmacy setting

What We Offer

We offer a competitive compensation + commission package in addition to a benefits package (medical, dental, and vision insurance, 401k). When determining compensation, we analyze and carefully consider several factors including job-related knowledge, skills, and experience.

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