Temporary Virtual Care Navigator

This is a fully remote position, open to applicants in United States.

📋 Description

• Collaborate with healthcare providers and staff to ensure a seamless patient-centered care experience.

• Manage incoming calls, schedule appointments, respond to inquiries, and follow up on member needs.

• Oversee virtual team scheduling, which includes creating schedule templates, conducting daily audits, member check-ins, sending reminders, and rescheduling as necessary.

• Prioritize and address provider message queues promptly.

• Assign and organize incoming faxes effectively.

• Handle records requests from initiation to completion.

• Assist with prior authorization processes.

• Collect copays and respond to questions regarding insurance coverage and cost of care.

• Process referrals to specialists, imaging providers, community resources, and employer benefits.

• Track referrals, maintain consistent communication and documentation, and ensure timely resolution.

• Train relevant stakeholders on the external referral process.

• Facilitate communication among specialists, clinic physicians, and patients.

• Utilize clinical judgment and critical thinking to determine the appropriate provider type and referral urgency.

• Generate and submit comprehensive referral packets that include relevant clinical documentation.

• Confirm that specialists receive referral packets and that patient appointments are scheduled in a timely manner.

• Operate within insurance benefit parameters to promote high-quality, cost-effective care.

• Address and troubleshoot downstream complications to prevent gaps in care.

• Support technological and service innovations for effective closed-loop referral communication.

• Perform other duties as assigned.

⛳️ Requirements

• A minimum of 3 years of relevant experience; experience in a Primary Care setting is preferred.

• High school diploma or GED is required.

• Proficiency in Google spreadsheets and/or Excel is essential.

• Experience in database management and data tracking is necessary.

• Access to a quiet and private remote work environment is required.

• High-speed internet connectivity is essential.

• Willingness and ability to work Thursdays and Fridays from 8 a.m. to 5 p.m. EST.

• A Bachelor’s Degree or related medical experience is preferred.

• Experience in processing referrals for a medical group is preferred.

• Creative and adaptable, with effective obstacle management skills.

• Strong task execution abilities and excellent follow-through are required.

🏝️ Benefits

• Eligibility for a 401K plan.

• Opportunity for a remote work arrangement.