Member Services Navigator II - Mount Sinai Solutions
Tasks
- Answer benefits and billing questions
- Arrange scheduling and follow up
- Assist with access to medical records
- Assist with appointment scheduling
- Coach colleagues on complex navigation tasks
- Complete high priority customer navigation requests
- Conduct referral research
- Conduct service recovery
- Coordinate care across primary and specialty providers
- Coordinate with health center providers and staff
- Coordinate with insurers and pharmacies
- Develop subject matter expertise in navigation content areas
- Document and update knowledge management collateral
- Explain health benefits and financial responsibility
- Identify and access healthcare providers
- Identify opportunities to improve member experience
- Implement new navigation workflows and policies
- Implement process improvements
- Implement tailored navigation programming
- Liaise with internal customers team
- Maintain customer knowledge management and workflows
- Monitor service SLAs and escalate issues
- Obtain prior authorizations
- Participate in navigator recruiting
- Serve as expert on major customer
- Serve as single point of contact for member questions
- Train colleagues
- Troubleshoot technology for members
Perks/Benefits
- N/A
Skills/Tech-stack
Appointment Scheduling | Benefits Administration | Billing support | Care Coordination | Communication | Customer support | Knowledge Management | Medical records | Prior authorization | Referral management | Service Level | Service Level Agreement | Technology troubleshooting
Education
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