Patient Navigator-IR

Job Summary: The Patient Navigator-IR, coordinates access of care for patients through the healthcare system from point of referral. Gathers demographic and insurance data necessary for insurance verification and verifies insurance coverage and benefits. Responsible for submitting correct CPT codes and ICD 10 codes for IR referrals. Gathers needed medical information for review prior to scheduling Interventional Radiology procedures, including diagnostic imaging and testing, operative and progress notes, pathology reports, and any relevant treatment history. Accurately posts charges for IR procedures, and reconciles procedure documentation and supplies to ensure correct and timely posting. The data to include but not limited to: provider, billing area, place of service, and ICD/CPT with appropriate modifier(s) based on payor type and following payor guidelines. Works on edits in conjunction with PBO. The IR Patient Navigator functions as a liaison between patients, families, outpatient clinics, primary care physicians, and other support services. Performs other duties as needed.

Education and Experience: High School Diploma or GED required. Minimum one year experience in a medical office setting and or hospital based clinic required. Minimum two years working with radiology patients preferred.

Knowledge and Skills: Knowledge of medical terminology required. Knowledge of all medical insurances and how they are used in a hospital/clinical based facility required. Full knowledge of ICD-10 and CPT codes and how they are used in HMO authorizations required. Knowledge of both in-patient and out-patient settings preferred. Able to type 25 wpm; enter/edit data in computer; proficient at keyboarding using Microsoft Word, Excel, PowerPoint, Outlook, and LLEMR. Able to use a variety of office equipment and tools. Able to communicate effectively; respond positively under changing circumstances; maintain patient confidentiality and a positive, supportive attitude toward patients and their families, co-workers and staff from various departments. Interpret and understand patient records and various reports including, but not limited to, diagnostic procedures and lab results; think critically; problem-solve; make sound decisions using common sense; work well under pressure; organize and prioritize workload effectively; multi-task; recall information with accuracy and pay close attention to detail. Must be able to work independently with minimal supervision. Able to distinguish colors as necessary, write, hear, read and speak sufficiently for general conversation in person and on the telephone; identify and distinguish various sounds associated with workplace; see adequately to read computer screens and written documents necessary to position

Licensures and Certifications: Medical Assistant certification preferred.