Patient Insurance Navigator Team Lead

Overview

The Patient Insurance Navigator Team Lead is a working leader on the insurance navigation team. This role supports the team’s daily operations, in addition to managing center-related needs and providing patient support. The Lead is also responsible for executing all individual duties including but not limited to verification of patient eligibility and the pre-authorization services required. The lead will also serve as a go-to or mediator for team member needs, report and share feedback when required, and assist leadership in escalations, policy development, and team workflow management. This position is approximately 50% staff duties and 50% oversight and team performance support.

Responsibilities

Team Responsibilities:

• Aid and support director, manager, supervisors, and leadership with recruiting and onboarding new hires and fulfilling all training needs.
• Maintain and manage process improvement changes, payer updates, training documentation and guidance for Team; including but not limited to workflow changes, learning resource updates and policy maintenance.
• Actively watch and maintain teamwork queues for STAT exams, same-day appointment add-ons, and /or patients nearing date of service deadlines with missing action.
• Act as a resource and subject matter expert to team members, including assisting with any customer service escalation needs.
• Support leaders with phone and workqueue management as necessary.
• Provides interim supervision in the absence of other leaders.
  
  

Individual Responsibilities

• Verify patient’s insurance status and benefit eligibility.
• Accurately determine the patient’s un-met deductible, co-insurance, and co-payment amounts.
• Accurately and timely provide for any pre-authorization or pre-certification of services.
• Provide high level of customer service with goal of maintaining a low cancellation and auth denial rate while increasing Time of Service collection rates.
• Other duties as assigned.
  
  

Qualifications

Education:

• High School Diploma or equivalent required
• Associate’s or bachelor’s degree in business administration or related field preferred
  
  

Prior Experience

• Minimum 4 years’ relevant experience required
• Previous team leadership experience preferred
  
  

Special Qualifications

• Ability to understand basic medical terminology
• Knowledge of pre-certification process for insurance companies
• Ability to calculate deductible and co-insurance correctly
• Ability to communicate effectively to patients about their medical conditions and the financial aspects of their care
• Ability to represent the Center in a professional manner when interacting with patients, guests, physicians and their staff
• Ability to handle service issues professionally
• Ability to follow through with customers
• Share relevant information with other employees
• Volunteer to assist others when time permits
• Ability to type proficiently