Health Insurance Navigator/PSR
il y a 1 jour
Ithaca
Job Description Centralus Health Mission Our mission is to deliver high-quality care, empower our teams to success and improve the wellbeing of the communities we serve. Job Summary The Health Insurance Navigator / Patient Service Representative (HIN/PSR) is a hybrid, student facing position supporting the comprehensive health care and insurance needs of Ithaca College students and their families. This role is structured to dedicate approximately 60% of effort to Health Insurance Navigator responsibilities and 40% to Patient Service Representative functions, with flexibility to shift based on student volume, peak service periods, operational demands, and special projects. This position is intentionally evolving as Student Health Services expands education, outreach, and operational support. The successful candidate must be adaptable, flexible, and comfortable in a dynamic environment, with responsibilities that change in response to institutional priorities, accreditation standards, seasonal fluctuations, and emerging student needs. During periods when the College is on academic break and Student Health Center activity is reduced, the individual will be required to float and provide coverage at other CMA practices, based on organizational needs. This role requires availability for evening shifts until 7:00 p.m. and weekend coverage as assigned particularly during the academic year. The position reports to the Office Coordinator and works collaboratively with clinical staff, administrative teams, athletics, and campus partners. Student & Family Support • Provide one-on-one consultationsfor students and families regarding insurance coverage, benefits, cost of care, prior authorizations, and access to services both on and off campus., • Assist students with complex or recurring insurance issues, including nonparticipating providers, out of network care, repeated claims, and authorization challenges., • Proactively review clinic schedules to identify students who may benefit from early insurance consultation. Education, Outreach & Engagement • Serve as a forward-facing representativefor insurance education and student engagement., • Participate in and support outreach events, including but not limited to:, • Admissions activities, • Student and Family Orientation, • Move-in programming, • Summer on South Hill events, • Conduct tabling, workshops, and presentations focused on:, • How to use insurance on and off campus, • Urgent Care vs. Emergency Room vs. Health Center utilization, • Understanding deductibles, copays, referrals, and out of network coverage, • Student athlete insurance coordination, • Develop educational materials and digital content, including LCD screen messaging and handouts., • Act as a content creatorsupporting insurance education initiatives. Student Health Insurance Plan (SHIP) • Support SHIP enrollment and waiver periods., • Coordinate with PSR/front desk staff to ensure enrollment dates and deadlines are clearly communicated., • Assist students with enrollment, waivers, and insurance troubleshooting., • Participate in ongoing evaluation and improvement of SHIP workflows. Insurance Operations & Care Coordination • Initiate and track prior authorizations, including diagnostic imaging., • Support referral management and insurance coordination., • Manage athletic insurance, including secondary policy setup and athletic claims., • Identify high risk students with recurring insurance barriers and initiate early interventions. Reporting, Documentation & Compliance • Run and track reports including:, • Open orders, • Open diagnostic imaging, • Open referrals, • PCMH Dashboard metrics, • Enter and maintain accurate insurance related documentation, alerts, and follow up tracking., • Support AAAHC policies and procedures, including documentation updates., • Maintain confidentiality and regulatory compliance. Patient Service Representative Responsibilities (Secondary - Approximately 2 Days/Week) Front Desk & Patient Access • Greet, check in, and register patients; verify and update demographic and insurance information., • Assist students with consent forms and intake paperwork., • Answer phones, triage calls, and route messages appropriately., • Assist with admissions, discharges, transfers, and patient flow. Operational & Clinical Support • Provide PSR coverage during high volume periods, evenings, and weekends as assigned., • Support seasonal clinics and events, including flu pod operations., • Assist with diagnostic imaging workflows and follow-up., • Provide administrative support to providers and clinical staff. Shared & Project Based Responsibilities • Health Certifications:Assist during peak processing times and summer chart prep., • Leave of Absence (LOA) Tracking:, • Enter chart alerts noting LOA dates and status, • Coordinate follow up regarding student returns from leave, • Provider Credential Files:Support maintenance and organization., • Assist with SHIP initiatives, retreats, venue coordination, and operational projects., • Participate in the EPIC call scheduleas assigned., • Other duties as assigned. Floating & Cross Coverage Requirement • When Ithaca College is on academic break or Student Health Center operations are reduced:, • The employee will float to other CMA practicesas assigned, • Provide front office, insurance, or administrative support consistent with training, • Must be comfortable adapting to:, • Different clinical workflows, • Varying patient populations, • New teams and systems Role Evolution & Flexibility • This position is dynamic and evolving., • Duties may change based on:, • Student utilization patterns, • Enrollment and outreach cycles, • Accreditation and compliance needs, • Staffing requirements across CMA practices, • Successful candidates:, • Embrace change and new responsibilities, • Balance routine operational duties with project based initiatives, • Support evening, weekend, and floating assignments, • Contribute ideas to program growth and service improvement Key Attributes for Success • Flexible and adaptable, • Comfortable with evolving responsibilities, • Proactive and solution oriented, • Student centered and collaborative, • Able to work across multiple clinical settings and schedules Qualifications Required • High school diploma or equivalent., • Strong organizational, communication, and multitasking skills., • Comfort in student facing, publics peaking, and outreach settings., • Ability to handle confidential information with discretion., • Proficiency in Microsoft Office and electronic health record systems (EPIC preferred)., • Experience in healthcare administration, insurance navigation, or patient services., • Knowledge of health insurance, referrals, prior authorizations, and claims processing., • Ability to move up to 25 pounds occasionally., • Must be able to remain at a workstation and move around the workspace as needed to complete job tasks, with or without reasonable accommodation. Schedule & Work Hours • Primarily weekday hours during standard clinic operations, • Evening coverage up to 7:00 p.m.on a rotational basis during the academic year, • Weekend coverageas assigned, including Saturdays during the academic term, • Schedule may vary based on:, • Student demand, • Outreach and enrollment cycles, • Operational and staffing needs, • Floating assignments at other CMA practices during academic breaks Time Allocation • Health Insurance Navigator (HIN):Approximately 3 days per week Job Posted by ApplicantPro