Patient Insurance Navigator

The Patient Insurance Navigator is responsible for verification of patient eligibility, the pre-certification of services as required, ensuring coverages are updated, validating authorizations already on file, and providing price estimates upon request.

Facility: Durham Diagnostic Imaging | Location: Durham, NC | STATUS: Full-time

Responsibilities, Duties, Functions, Tasks (Outcomes)

•    Verify patient’s insurance status and benefit eligibility.

•    Accurately determine the patient un-met deductible, co-insurance, and co-payment amounts

•    Accurately and timely provide for any pre-authorization or pre-certification of services.

•    Communicate with center staff, referring offices, team members, leaders, and schedulers.

•    Provide high level of customer service with goal of maintaining low cancellation and auth denial rates while increasing Time of Service collection rates.

•    Meet or exceed established productivity standards.    

•    Meet or exceed established quality assurance standards and maintain customer experience expectations.

•    Meet or exceed established error standards.

•    Meet or exceed expectations related to phone and instant message response time and quality of service provided in those interactions.

•    Ensure patients that are not approved or covered for services are notified timely and provided all options including rescheduling and waivers.

•    Provide price estimates prior to scheduling when requested.

•    Other duties as assigned.

Requirements

Education:

High School Diploma or GED

Prior Experience:

2 years’ experience insurance certification

Special Qualifications:

•    Ability to understand basic medical terminology.

•    Knowledge of pre-certification process for insurance companies.

•    Ability to calculate deductible and coinsurance correctly.