Work Shift:

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advance technology. Capital Health is a five-time Magnet-Recognized health system for nursing excellence and is comprised of 2 hospitals. Capital Health Medical Group is made up of more than 250 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Position Overview:

ESSENTIAL FUNCTIONSServes as a resource and provides support, education, coordination of services and other assistance as needed to patients, enabling them to become active participants in health care decisions. Works collaboratively with other departments to coordinate seamless use of services for patients.Guides patients through the healthcare system and ensures that patients and members are able to access culturally and linguistically appropriate services in a timely and cost effective manner. Facilitates the process to assure quality support groups are available to participants.Advises patients of service costs and alternative sources of funding. Verifies insurance of all patients and works with health insurance providers to determine coverage and benefit limits. Re-submits appeals related to denials. Works with other members of the program's interdisciplinary team, insurers and administrative other staff at Capital health.Submits requests for and obtains procedure authorizations and pre-certifications from health insurance providers as needed for all patients. Meets payor authorization requirements to ensure maximum reimbursementCollaborates with patients, families, healthcare providers and other internal staff to address a wide variety of patient health insurance matters. Serves as liaison with internal staff, insurance companies, mental health agencies, and other agencies to process and monitor department contracts.Assists with the accreditation process of becoming a bariatric Center of Excellence and ensuring continuous compliance with the MBSAQIP requirements.Maintains policies and procedures, patient education, outcomes data collection, quality improvement efforts, and education of relevant staff in the various aspects of the metabolic and bariatric surgery patient with a focus on patient safety.Collects accurate patient demographic and billing information in a timely manner, and maintains records of same.Coordinates surgeries and procedures. Arranges patient pre-testing with appropriate departments and is responsible for obtaining patient medical clearance. Places surgical confirmation calls in advance of scheduled surgery or procedure date. Schedules post-operative follow-up visits with providers.Coordinates registry activities and running routine reports to facilitate patient tracking.Collaborates with Community Education for planning, scheduling and facilitating community lectures and support groups.Performs other duties as assigned or needs arise.

MINIMUM REQUIREMENTSHigh School Diploma. Associate's degree in related field preferred. Patient Navigation Certification preferred.Two years experience in healthcare. Two years experience in obesity disease management and in a weight loss surgery program preferred.

PHYSICAL DEMANDS AND WORK ENVIRONMENTFrequent physical demands include: Walking , Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Wrist position deviation , Pinching/fine motor activities , Keyboard use/repetitive motionOccasional physical demands include: Taste or Smell , Talk or HearContinuous physical demands include: Sitting , StandingLifting Floor to Waist 10 lbs. Lifting Waist Level and Above 10 lbs.Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Accurate Depth Perception, Accurate Hearing

Offers are contingent upon successful completion of our onboarding process and pre-employment physical.  Capital Health will require all applicants to have an annual flu vaccine prior to start date, with the exception of individuals with medical and religious exemptions.

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