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Gifthealth · 1 day ago

Patient Navigator

United States

Full-time

Remote

New Grad, Entry Level

Gifthealth is revolutionizing healthcare by simplifying the management of prescriptions and health services. The Patient Navigator will provide exceptional customer service by coordinating cases for patients and healthcare practitioners, educating them on the enrollment process, and confirming scheduled deliveries of prescribed therapies.

Health CarePharmaceuticalSoftware

Responsibilities

Provide subject matter expertise of program requirements and reimbursement status while maintaining a high level of customer service, having a sense of urgency, being reliable, error free data entry skills, utilizing active listening skills while maintaining proper phone etiquette, utilizing great verbal and writing skills, and maintaining teamwork spirit

Single point of contact and voice for patients. Works as a patient advocate and always demonstrates compassion

Performs reimbursement related activities, such as benefit investigations, to providers and/or patients

Provide exceptional customer service to internal and external customers; resolve customer requests in a timely and accurate manner; escalate complaints according to defined SOPs

Maintain frequent phone contact with patients, third party customer service representatives and pharmacy staff

Validates completeness of all required information within case notes based on documentation or communications received from calls, providing notification of any urgent orders, shipping related issues and any errors, complaints or adverse drug events to the appropriate 3rd party or system

Reports on all Adverse Events (AE) disclosed in alignment with training and Standard Operational Procedures (SOP)

Extensive knowledge of HIPAA regulations and follows all company policies

Meet performance standards in alignment with predefined metrics or KPIs

Typically receives little instruction on day-to-day work and general instructions on new assignments

Ability to be flexible and maintain composure as duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice

Qualification

High-volume call center experienceHealthcare benefit investigationHIPAA regulationsMicrosoft Office proficiencyCommunication skillsProblem-solving skillsInterpersonal skillsCritical thinking skillsTeamwork

Required

High School Diploma or GED required

Experience working in a high-volume call center is required

Thorough understanding or working knowledge of commercial and major medical insurance programs, billing requirements, healthcare benefit investigation processes, prior authorization and appeal filings

Knowledge of private payers, pharmacy benefits, medical benefits, Medicare Part D, Medicaid and alternate funding resources

Demonstrated organization and problem-solving skills to handle patient conversations identify issues and address needs

Must have comfort level multi-processing across multiple applications concurrently while capturing case information

Proficient with Microsoft Office Program Suite and Lotus Notes Suite including Excel, Word, Outlook and SharePoint

Ability to maintain professional communication skills and an understanding of how to maintain a courteous attitude toward customers and fellow employees

Requires critical thinking skills, analytical skills and the ability to work with minimal supervision

Requires strong communication (verbal and written, clear and concise), customer service and interpersonal skills

Must be able to take appropriate action in a stressful environment

Ability to work independently or as a team member

Strong communication skills (verbal and writing) while maintaining a high degree of customer service

Ability to sit for extended periods of time while working at a computer and on the phone throughout the workday

Ability to engage in continuous phone and computer use, including navigating multiple systems simultaneously, for the duration of the shift

Ability to perform repetitive motions for an entire shift, including typing, mouse use, and phone handling

Ability to view and read information on a computer screen for prolonged periods

Ability to communicate clearly and professionally via phone, email, and internal systems

Ability to manage a high volume of inbound and outbound calls while maintaining attention to detail and accuracy

Ability to work in a remote environment with minimal distractions and maintain productivity and performance standards

Ability to adapt to changing priorities, workflows, and processes in a fast-paced environment

Ability to meet attendance, schedule adherence, and performance expectations, including flexibility for occasional extended hours or weekends as business needs require