Staff members from Prism health North Texas Oak Cliff Health Center Clinic

Financial Navigator Job – Dallas, TX

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Our Core Values

The culture at Prism Health North Texas is built on our shared Core Values.  We make hiring, firing, promotion and performance review decisions based on these values and behaviors, so it is important that you also share these Core Values:
  • We are solution seekers. The organization’s founders found solutions even during the AIDS crisis of the 80’s; we remain proactive, thrive on change, and always willing to take the lead.
  • We have a can-do attitude. We are flexible, agile, and never say, “It’s not my job.” We always seek growth, and we are never late but always willing to stay late to see the last patient.
  • We are mission-driven. We are committed to health equity; recognize all contributions are meaningful and valued. It is never about the me or I, but about the we.
  • We care about people. We celebrate diversity, equity, and inclusion; we are kind and practice acts of kindness, all in service to our patients and each other.

General Description: 
The Financial Navigator manages eligibility and insurance verification for patients. The Financial Navigator’s goal is to provide continuous documentation support by helping patients maintain eligibility requirements for service continuity. The Financial Navigator is to work with patients to determine the payor source that should be used for the patient.

Responsibilities

Specific Responsibilities of the Job: 
  • Meets with patients to complete eligibility documentation. 
  • Maintain eligibility documentation for new and existing outpatient medical care patients.  
  • Responds to patients’ communication in a timely manner to prioritize eligibility maintenance. 
  • Document eligibility status and any related notes in the EHR. 
  • Upload eligibility documentation and agency documents into document portal and EHR. 
  • Conduct insurance verification, eligibility, and benefits before each medical visit and ensure all prior authorization is complete prior to delivery of ambulatory practice services. 
  • Assists patients in understanding insurance benefits and patient financial responsibilities prior to services being rendered.   
  • Manage patient’s health record to ensure that all required information is correct and complete in the Prism Health North Texas (PHNTX) system and information is available to provide services.     
  • Refer patients identified with multiple needs to clinic case managers for assessment. 
  • Other duties as assigned. 
 
Direct Reports: None. 

Skills & Qualifications

Required Knowledge, Skills, and Abilities: 
Job Requirements: 
  • Proficiency in Excel, Word, and Outlook.  
  • Demonstrated knowledge and experience working with clients with mental health and substance use disorders. 
  • Demonstrated ability to handle multiple responsibilities to meet tight deadlines in a complex environment.  
  • Demonstrated knowledge of physician reimbursement, medical terminology, ICD-10, CPT and HCPCS coding 
  • Ability to make decisions related to appropriate client care. 
  • Ability to effectively communicate in verbal and written formats. 
  • Ability to establish effective working relationships with clients. 
  • Ability to manage and work effectively in the required electronic medical record, database, or document portal. 
  • Ability to work in a multi-site work environment.  
 
Education and Experience: 
  • A high school degree/diploma or GED.  
  • 5 years of experience in insurance verification and billing in a comprehensive and specialty care environment. Experience working with third-party billing service preferred.  
  • Certification in coding and billing preferred.  
  • Bilingual in English/Spanish is preferred. 
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