[Hiring] Specialty Navigator @UnitedHealth Group

Role Description

This role involves reviewing complex referral requests and evaluating and assigning appropriate specialists for the patient. The Specialty Navigator works with patients and providers to understand services being requested and coordinates care both within Reliant and Atrius Health and with external partners.

• Reviews referral information from clinicians for pertinent information regarding tests, consultations, and procedures
• Verifies demographics and insurance information
• Reviews for referral information from work queue for pertinent information regarding referral requests
• Redirects patients with managed care products appropriately ensuring clinical handoff is safe using expertise of specialty nurses
• Explains insurance benefits and options to patients
• Notifies patients of scheduled appointments and confirms appointments by mail
• Promotes the Reliant and Atrius Health System of Care by highlighting internal providers and their expertise
• Schedules patients for tests, consultations, services, and procedures with other departments, local private offices, and/or outside vendors/providers
• Answers phone calls, faxed requests, and other inquiries relating to referrals
• Assists in resolving billing and denied referral matters as they relate to the referral process
• Works in collaboration with the Practice’s Benefits Coordinator to maintain cost control
• May coordinate second opinion requests
• Supports roles within the Navigator and trains as needed
• Participates in problem-solving activities, focusing on productivity and quality
• Complies with health and safety requirements and with regulatory agencies

Qualifications

• High School Diploma/GED (or higher)
• 1+ years of receptionist, admin support, or healthcare-related experience
• Intermediate level of proficiency with MS Office tools
• Must reside in Massachusetts

Requirements

• 1+ years of experience working in a medical front office position performing duties such as scheduling appointments, checking patients in/out, insurance verification, collecting co-pays, and maintaining medical records
• Proficiency in Microsoft Office (Word, Excel, and Outlook)
• Knowledge of Epic EMR software
• Ability to learn new software (EPIC/EMR) and flexibility to attend new hire training
• Previous call center experience

Benefits

• Paid Time Off which you start to accrue with your first pay period plus 8 Paid Holidays
• Medical Plan options along with participation in a Health Spending Account or a Health Saving account
• Dental, Vision, Life & AD&D Insurance along with Short-term disability and Long-Term Disability coverage
• 401(k) Savings Plan, Employee Stock Purchase Plan
• Education Reimbursement
• Employee Discounts
• Employee Assistance Program
• Employee Referral Bonus Program
• Voluntary Benefits (pet insurance, legal insurance, LTC Insurance, etc.)