Patient Navigator - Adult Colon and Rectal Surgery

The Patient Navigator 2collaboratively supports and guides an identified patient population through the process of receiving care within a designated specialty. Coordinates the flow of patient care between the practice and other healthcare providers across the continuum of care. Performs various administrative functions, including registration, scheduling, billing, and precertification/authorizations, while conveying a positive image of the clinic and providing excellent customer service.

1. Patient Coordination
   1. Schedules appointments within clinic according to established procedures.
   2. Facilitates coordination among all providers and hospital for patient care. Schedules pre-operative testing, lab workups, assessments, clearances, etc. and works with patient to assure completion.
   3. Informs patients about the care process including workup, post-operative period and follow-up, to facilitate efficient and effective care. Enables informed patient decision-making by providing knowledge and education on the bariatric process and assesses patient understanding; works interactively with all providers involved in the patients care to ensure comprehension.
   4. Gathers all tests results and presents to the physician for review. Contacts the patient with any abnormal tests results for continued testing if needed.
   5. Schedules patients follow up appointments after procedure is completed, both within clinic and with other providers as needed.
   6. Takes patient calls, assesses situation and determines necessity and urgency for appointment based on status; communicates with physician and/or other providers as needed to provide best care.
2. Patient Accounts and Access
   1. Serves as resource and liaison between patient, clinic and insurance companies to facilitate understanding of payment options.
   2. Requests records from external sources as needed. Completes and submits all paperwork effectively to minimize delays and/or denials, while adhering to all applicable regulations.
   3. Performs insurance verification/eligibility; secures pre-authorizations and/or referrals effectively.
   4. Estimates cost of service and the patients' responsibility, analyzes and documents the patients' account history and assists patients with financial assistance and referrals within scope of practice.
   5. Collects payments from patient, insurance company, or other sources as appropriate. Coordinates appeals process as necessary or appropriate.
3. Other duties as assigned.
   1. Facilitates support groups as needed or assigned.
   2. Assists in the development and maintenance of educational programs to practice team members, medical staff, community or others to further the provision of exceptional care.
   3. Implements policies and practices, and provides input into performance improvement ideas, particular to the scope of care provided for this specific patient population. Identifies problems and facilities solutions; communicates findings and suggestions.
   4. Acknowledges patient and family values in all aspects of their care and models behaviors to other team members both within and outside of practice.
   5. Monitors the expenditures of the practice. Maintains expenditures within budget guidelines to include volume.
   6. Obtains and maintains high level of information and expertise regarding specific patient population and procedural specialty.

Experience - 3 years administrative experience in a physician practice providing a designated procedural specialty, including registration, scheduling, insurance, and billing

Education - High School diploma