Patient Care Navigator I

Position Summary

The Patient Care Navigator (PCN) serves as the front-line specialist responsible for patient intake and registration, demographic collection, payment collection, insurance and SFDP eligibility and verification, and navigation support for patients accessing medical, dental, and behavioral health services at Mary’s Center. This role serves as administrative support for clinical services and helps coordinate participant care across interdepartmental teams

Reportability

The Patient Care Navigator will report directly to the Patient Care Operations Manager and Director of Operations

Essential Duties and Responsibilities

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

• Greet and welcome patients, visitors, and others to Mary’s Center
• Provide Information regarding all Mary’s Center service lines and how to access them
• Provide outstanding customer service to our patients and the public
• Follow HIPAA confidentiality guidelines
• Serves as the front-line team member assisting participants within Medical, Dental, and Behavioral Health services.
• Serve as a liaison for participants between Mary’s Center clinical and non-clinical services as needed.
• Navigates and understands all workflows within EHR system related to participant scheduling, registration, check-in, payment collection, SFDP, insurance eligibility and verification, and other front office duties.
• Checks in and registers participants in-person and virtually.
• Completes comprehensive registration for new and returning participants.
• Verify and update participant demographics, contact information, emergency contacts, family relationships, PCP information, and FPL data. Collect and verify insurance information, including Medicaid, Medicare, and commercial plans.
• Enroll participants in Mary’s Center’s Sliding Fee Discount Program.
• Inform and assist participants with local and statewide entitlement programs.
• Assists in scheduling follow-up/recall appointments ensuring continuity of care.
• Confirms participant appointments by phone, text, patient portal, or email.
• Assists in provider panel management, scheduling, and rescheduling.
• Monitors status of reception areas, updating appointment status by end of the day, alerting clinical staff of unusually long participant waiting times, or obtaining assistance in any unusual situations including participant conflicts.
• Coordinate interpretation services for participants with language access or ASL needs.
• Performs other clerical support functions; scanning, telephone encounters, documentation of appointments or referrals, and completing medical records release forms.
• Perform administrative chart reviews such as HIPAA, Consent to Treatment, ASQ Calculate and collect patient copays, deductibles, sliding fee scale discounts, and balances.
• Scan and upload required documents (ID, insurance cards, income verification)
• Follow the policies and procedures, workflows, and/or guidelines.
• Connect participants to community resources, including transportation, pharmacy services, and other supportive resources. Exhibits and promotes a standard of excellence in the performance of all duties and interactions with participants, co-workers, and outside contacts.
• Participate in required internal and external resource and workflow training.
• Performs other duties assigned by a supervisor.

Qualifications

The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience – Minimum of High School Diploma or GED equivalent.

Language Requirement: Ability to communicate effectively in English is required. Ability to communicate effectively in at least one language commonly spoken by participants served by the program (e.g., Spanish or Amharic) is strongly preferred or required based on role assignment and program needs.

Physical Demands – Regularly required to sit; frequently required to reach with hands and arms, walk, stoop, kneel, crouch, talk or hear; must be able to lift objects up to twenty-five (25) pounds. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

Work Environment – Mostly in a typical office and/or home setting with quiet to moderate noise level. May be exposed to extreme cold, heat, and humidity due to outside weather conditions.

The Benefits:

• Health Insurance: medical, dental & vision – plus retirement options through 403(b) contribution and investment opportunities
• 25 days of paid leave annually (in addition to paid holidays), plus 5 educational days
• Tuition reimbursement of $2000/year towards education assistance and professional development
• Transportation subsidy via metro & bus
• Employee Assistance Program (EAP)