Insurance Navigator

Job Details

Working title: Insurance Navigator
Classification title: Administrative Services Coordinator 1
Division: Community Health Center
Program: Care Management
Reports to: Care Management Services Manager
FLSA status: Non-Exempt:
Full-Time
Schedule: Monday-Friday; 8am-5pm
Wage Range: $19.21 to $23.48 hourly; depending on number of years of transferrable experience and internal equity

Serving the Yellowstone County community and south-central Montana for nearly 50 years, River Stone Health is an essential provider of personal and public health services.
Health, Education, Leadership and Protection – HELP is what we do. From medical, dental and behavioral healthcare; home care and hospice; public health services like immunizations, WIC, health promotion and restaurant inspections; and educating the next generation of health professionals, our expertise spans all ages and stages of life. Underlying principles of access, affordability, compassion and quality in all interactions, River Stone Health improves life, health and safety for all of the communities we serve.

Works with patients and community members to provide education and assistance related to insurance options and enrollment in Medicaid, Healthy Montana Kids, Health Insurance Marketplace and Medicare.

• Insurance Navigation 70%
• Educate and assist individuals to enroll in Medicaid, Healthy Montana Kids (HMK), Health Insurance Marketplace, and Medicare.
• Maintain knowledge of eligibility requirements for Medicaid, HMK, Health Insurance Marketplace, and Medicare.
• Maintain accurate documentation in the electronic medical record (ECW) for insurance assistance and enrollment encounters.
• Provide insurance enrollment assistance to ensure accurate and timely submission of required documentation.
• Maintain a caseload of individuals that have applied for health insurance to facilitate completion of application and submission of required documentation.
• Monitor for active health insurance coverage and enter into the electronic medical record (ECW) in a timely manner.
• Schedule and monitor daily insurance appointments to ensure individuals are seen in a timely manner.
• Monthly outreach at RSH Satellite Clinic locations to provide insurance enrollment in underserved populations (Worden, Bridger, Joliet, WOW bus) and other locations as identified by the supervisor.
• Patient Outreach 25%
• Outreach to patients presenting to River Stone Health Clinic who are listed as self-pay or without insurance, to inform them about available health insurance options.
• Assist patients with eligibility requirements and enrollment in the sliding fee scale discount program.
• Keep immediate supervisor and designated others accurately informed regarding work progress, including present and potential issues, as well as suggestions for new or improved ways of addressing such concerns.
• Attend meetings, conferences, workshops, and training sessions to remain current on principles, practices, and new developments relevant to assigned work areas.
• Return calls and respond to patients’ questions and comments in a courteous and timely manner.
• Ensure that patients have access to primary medical and dental services by assisting them to understand the role of a primary care provider, select a provider, and make appointments or other necessary connections.
• Educate staff on the importance of a team approach to patient care, emphasizing the collaborative effort between clinical and nonclinical staff (including physicians, nurse practitioners, physician assistants, nurses, medical assistants, educators, front desk staff, schedulers, etc.) to achieve stated objectives.

• Perform other duties as assigned in support of River Stone Health’s mission and goals.

• High School diploma or equivalent
• Experience working in customer service environment, in person and on the phone
• Any combination of experience and training which provide the equivalent scope of knowledge, skills, and abilities necessary to perform the work.

• Insuranc…