Care Access Navigator: Insurance & Coverage Support

Family Health Center; Rhinelander (WI); On-site; USD 25,000 - 39,000; Full time

Job summary

Family Health Center in Rhinelander, WI seeks a Managed Care Coordinator to handle insurance requirements and provide case management support across patient care settings. You will verify eligibility, communicate benefits, and help coordinate coverage for services.

The role collaborates with providers, carriers, and Patient Assistance Counselors to maximize reimbursement, arrange prior authorizations, and guide patients through cost estimates and payment options.

Qualifications

• High school diploma or equivalent.
• Minimum of two years’ experience in a medical/dental business office or healthcare setting.
• Understanding of insurance eligibility and benefit verification.
• Preferred graduation from a Medical Assistant, Health Unit Coordinator, or Health Care Business Services program.

Responsibilities

• Completes managed care insurance requirements for services ordered or provided by health system providers.
• Monitor services requiring case management by reviewing records and communicating with patients, providers, and insurers.
• Contact patients to obtain insurance information, communicate cost estimates, and relay care details.
• Verify insurance eligibility for each visit and update patient accounts.
• Provide patient counseling on expected payments, pre-pay, and non-covered services.
• Submit and verify prior authorizations with providers and care teams.
• Document all patient interactions and maintain accurate records.
• Assist with appeals, referrals, prior authorizations, and denied claims to maximize reimbursement.
• Refer underinsured or uninsured patients to Patient Assistance Counselors.
• Maintain reliable attendance and adhere to scheduled work hours.
• Performs other duties as assigned.

Education

High school diploma or equivalent

Graduation from Medical Assistant / Health Unit Coordinator program (preferred)

Job description

Family Health Center in Rhinelander, WI seeks a Managed Care Coordinator to handle insurance requirements and provide case management support across patient care settings. You will verify eligibility, communicate benefits, and help coordinate coverage for services.

The role collaborates with providers, carriers, and Patient Assistance Counselors to maximize reimbursement, arrange prior authorizations, and guide patients through cost estimates and payment options.