Health Center Navigator

Health Center Navigator

The Health Center Navigator assists patients/clients in accessing health insurance coverage and other resources to reduce barriers to care. This position works with uninsured and underinsured patients/clients to identify available coverage options, including Medicaid, Marketplace plans, and the Family Health Center sliding fee scale. The Health Center Navigator assists patients/clients with the application and enrollment process, coordinates with internal departments to ensure coverage information is accurately documented and connects patients with community resources based on identified needs.

This position also supports outreach and education efforts. This position is located at our Pike County FHC. 1.0

FTE, hours to be determined.

The essential functions may include, but are not limited to the following:

• Supports and adheres to the Organization's Mission, Vision, and Values.
• Successfully completes required Health Insurance Navigator training and certification and maintains certification as required.
• Complies with applicable Navigator requirements and maintains current knowledge of health insurance enrollment policies and procedures.
• Assists uninsured and underinsured patients in identifying and obtaining available health insurance coverage, including Medicaid, Marketplace coverage, and other applicable programs.
• Assists in obtaining the Family Health Center sliding fee scale discount by collecting and verifying documentation required to determine eligibility based on Federal Poverty Level guidelines.
• Assists with Medicaid applications, including presumptive eligibility and full Medicaid enrollment, and provides education regarding available Marketplace coverage options.
• Coordinates with Registration and Billing staff to ensure newly obtained insurance coverage is accurately documented in the Electronic Health Record (EHR).
• Monitors self-pay patients and follows up on potential changes in insurance coverage to support timely and accurate billing.
• Assists with scheduling appointments and connecting with appropriate providers and services based on identified needs.
• Identifies and develops relationships with community organizations and agencies to support patient enrollment, outreach, education, and access to resources.
• Connects patients/clients with community resources and provides follow-up to assist with identified social and economic needs.
• Supports in navigating barriers to care, including access to insurance, healthcare services, and community resources.
• Maintains accurate and timely documentation of patient/client interactions, applications, services, and follow-up activities in the EHR.
• Protects patient and personally identifiable information and maintains confidentiality in accordance with HIPAA and organizational policies.
• Participates in required meetings, training, and continuing education activities.
• Performs other duties as assigned.

Experience working with health insurance enrollment, patient assistance, or community resources preferred. Experience working with diverse populations and individuals experiencing barriers to healthcare access preferred. Experience in a healthcare, community service, or customer service setting preferred.

Mental:

• Strong attention to detail and accuracy when handling patient and insurance information.
• Ability to understand and apply health insurance requirements, policies, and procedures.
• Strong organizational and problem-solving skills with the ability to prioritize and manage multiple responsibilities.
• Ability to communicate effectively and professionally with patients, staff, insurance representatives, and community partners.
• Ability to maintain confidentiality and exercise sound judgment when handling sensitive information.

• Ability to perform repetitive motions, including typing for EHR documentation.
• Able to perform essential job functions effectively.
• Sufficient visual and hearing acuity to complete work accurately.
• Prolonged sitting at a desk with frequent computer use.
• Manual dexterity is necessary to operate computers and other office equipment.

Education:

High School Diploma or GED required. Certification:
Health Insurance Navigator certification required within the timeframe established by the organization. Licensure:
Valid Driver's License

Strong verbal and written communication skills. Effective customer service and interpersonal skills. Ability to explain complex information in an understandable manner. Strong organizational and time management skills. Ability to work independently and as part of a team. Ability to prioritize multiple tasks and meet deadlines. Proficient computer and data entry skills. Ability to maintain confidentiality and exercise sound judgment. Ability to build positive relationships with patients, staff, and community partners.