3 Navigator Jobs in Pearland, TX
Kelsey-Seybold Clinic is Hiring a Navigator Near Pearland, TX
Responsibilities
The Referral Navigator Representative provides administrative support for the referral navigator department. This position is primarily responsible for coordinating with KS clinical staff to assist with the entry of prior authorization requests for utilization review.
This includes interpretation and communication of covered benefits and exclusions, prior handling and appropriately directing prior authorization status requests received from KSC staff and assisting with requesting clinical updates.
Other duties as assigned.
Job Title : Referral Navigator Representative
Location : Pearland Administrative Office
Department : Utilization Management
Job Type : Full Time
Salary Range : $ 35,240 $43,535 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)
Qualifications
Education
Required : High School diploma or GED from an accredited program
Preferred : Graduate from accredited medical assistant program
Experience
Required : 2 3 years of managed care experience either in a physician office or hospital setting health plan,
ACO, or other managed care setting.
Experience in creating authorization requests or billing Medicare or private insurance companies.
Preferred : Knowledge of CPT & ICD 10 Coding methodologies and billing.
Prior experience with precertification and / or utilization management.
Knowledge of insurance payer specific prior authorizations requirements preferred.
License(s)
Required : N / A
Special Skills
Required : Knowledge of medical terminology, coding, COB payment, and prior authorization processes.
Alpha / numeric data entry and basic PC Literacy.
Demonstrate a working knowledge of industry standards processing.
Understanding of Health plan benefits and financial obligation interpretation
Preferred : Strong knowledge of HMO, PPO, and POS plan types a plus including Medicare and commercial
health plans.
Benefit interpretation a plus
Other
Required : Excellent verbal communication and time management skills
Preferred : N / A
Working Environment : Office
About Us
Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston’s fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties.
Our clinics are comprised of more than 600 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner.
Enjoy the rewards of a successful career while maintaining a work / life balance by joining our team today and changing the way health cares.
Why Kelsey-Seybold Clinic?
- Medical, Vision, and Dental
- Tuition Reimbursement
- Company Matching 401K
- Employee Reward and Recognition Program
- Paid time off for vacation, sick, and holidays
- Employee Assistance Program
- Continuing Medical Education allowance
Referral Navigator Representative
Last updated : 2024-06-25
Job Summary
Full Time
Ambulatory Healthcare Services
$69k-85k (estimate)
06/26/2024
09/24/2024
kelsey-seybold.com
PASADENA, TX
1,000 - 3,000
1949
MIKE FITZGERALD
$200M - $500M
Ambulatory Healthcare Services
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About Kelsey-Seybold Clinic
Kelsey-Seybold Clinic is Houston's premier multispecialty group practice, founded in 1949 by Dr. Mavis Kelsey. More than 480 physicians and allied health professionals practice at 25 locations in the Greater Houston area. Kelsey-Seybold offers quality medical care in 55 medical specialties. The organization operates the largest freestanding Ambulatory Surgery Center in the state of Texas and offers state-of-the-art Varian TrueBeam and Varian Edge radiation therapy technology at a nationally accredited Cancer Center. An accredited Sleep Center, comprehensive laboratory services, advanced imagin...g and diagnostics, 17 onsite Kelsey pharmacies, MyKelseyOnline (a secure web portal for patients to communicate with their Kelsey-Seybold doctors, get most test results, and schedule appointments), and Telemedicine Services E-visits and Video Visits with Kelsey-Seybold medical personnel are part of its comprehensive offerings. Kelsey-Seybold partners with major insurers to offer value-based commercial health plans. KelseyCare Advantage, a Medicare Advantage plan offered to Houston-area beneficiaries and affiliated with Kelsey-Seybold Clinic, has achieved the coveted 5-out-of-5-star rating from the Centers for Medicare and Medicaid for five consecutive years. Kelsey-Seybold has been recognized by the National Committee for Quality Assurance (NCQA) as the nations first accredited Accountable Care Organization and a Level 3 (highest) Patient-Centered Medical Home. Kelsey-Seybold has many physicians in the Greater Houston area certified for excellence in diabetes and heart and stroke care by the NCQA. In addition to these recognitions, Kelsey-Seybold is home to a nationally accredited Breast Diagnostic Center, and Endoscopy Center.
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The job skills required for Navigator include Patient Care, Data Entry, Managed Care, Time Management, etc. Having related job skills and expertise will give you an advantage when applying to be a Navigator. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Navigator. Select any job title you are interested in and start to search job requirements.
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