Patient Navigator - Denials/Medical Appeals Specialist

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Requirements:

• Minimum 3 years experience in financial counseling, patient financial services or insurance follow up in a healthcare or health insurance environment.
• Minimum two years experience providing patient communication, researching, and documenting patient insurance information.
• Billing and coding experience required, medical billing certificate preferred.
• Excellent communication and customer service skills.
• Bilingual Spanish/English strongly preferred.
• High school diploma or equivalent required, Associate degree preferred.

Responsibilities:

• Primary point of contact for effective claim follow-up, patient follow-up, and denial resolution.
• Provide updates on any/all benefits investigations related to the member’s financial responsibility.
• Works as a patient advocate and functions as a liaison between the patient, insurance company and/or medical office(s).
• Demonstrates advanced understanding of claim needs and ability to accurately perform needed billing activities.
• Processes insurance/patient correspondence and maintains history to include correspondences between payer, provider and patient.