Transitional Care Navigator

Transitional Care Navigator

General Description:

The TCN has the primary responsibility of handling initial customer contact either in person, via the web, or over the telephone. Customer contacts might be with the patient, care giver, referral source, commercial account, or payor. The TCN ensures all customer orders are received, qualified, and processed in accordance with procedure, and in a timely, efficient, accurate, and courteous manner. Collaborates with the sales team to execute on opportunities and provides the best-in-class customer service to our patients and customers. Processes sales orders from receipt to delivery and acts as a

communication leader throughout the process.

RESPONSIBILITIES:

· Ensure positive interactions with internal/external customers (written & verbal)

· Always maintain proper confidentiality. Adhere to all state and federally mandated documentation standards

· Maintain proper telephone etiquette using a standardized greeting that identifies the organization

· Collaborate with sales team members (CTL/TM) for appropriate clinical documentation to assure a smooth transition of care, as needed

· Assess the needs of the customer/referral source and act accordingly

· Accurate referral entry as described by company policies and procedures to include all appropriate documentation to bill for services

· Evaluation and determination of eligibility based on specific payer guidelines.

· Verify insurance benefits; evaluate patient/customer’s need, vendor pricing, private pay issues, and/or third-party reimbursement possibilities.

· Assist referral sources and patients with the selection of appropriate equipment, supplies, and services

· Process and key delivery ticket to accurately reflect the equipment/supplies provided.

· Resolve customer/referral concerns and complaints by identifying problems and coordinating appropriate corrective action.

· Accurately and clearly instruct referral source and/or sales team (CTL, TM) on insurance qualification guidelines for orders received.

· Communicate within our organization to provide continuity of care

· Understand and execute goals set for the team

· Under the direction of supervisor, assist the Central Intake Team with planning and prioritizing activities to achieve results

· Serve as an expert on qualifications for required products/services according to payor guidelines and requirements. Be able to communicate guidelines effectively and with excellent customer service skills.

· Provide a motivational atmosphere for the team and lead by example

· Assist in training inexperienced team to be excellent contributors

· Communicate effectively with locations and departments to ensure the highest level of customer service and satisfaction.

· TCC is responsible for referrals during the organization’s weekday hours as assigned

· TCC is on a scheduled rotation for weekday after-hours rotation and weekend coverage rotation

Requirements QUALIFICATIONS:

· Associates degree or equivalent experience required· Exceptional phone and customer relations skills· Healthcare experience and knowledge of medical terminology preferred· Previous experience with a medical billing system preferred· Sales and Team relationship building· Ability to multitask