Patient Navigator/Data Entry Clerk

Paycom - ATS; Laredo (TX); On-site; USD 32,000 - 45,000; Full time

Job summary

Central Clinic in Laredo, TX is seeking a full-time Eligibility & Enrollment Specialist to help uninsured patients access state program benefits. You will assess eligibility, gather documentation, and coordinate with providers and community partners to streamline services.

Key duties include interviewing clients, maintaining case notes, preparing narrative reports, and ensuring timely follow-ups while upholding HIPAA and privacy standards. Bilingual English/Spanish preferred.

Qualifications

• Graduate from an accredited high school or GED.
• Two years’ experience in community health care.
• Bilingual in English and Spanish preferred.
• Excellent data entry and record-keeping skills.
• Ability to work with diverse communities and maintain confidentiality.

Responsibilities

• Provide eligibility and renewal assistance for state programs.
• Interview clients to gather case management information.
• Refer to other agencies as needed.
• Maintain patient records and logs.
• Comply with HIPAA and protect patient confidentiality.
• Coordinate services with providers and community partners.

Skills

Bilingual English/Spanish

Case management

HIPAA compliance

Data entry

Interpersonal skills

Education

High school diploma or GED

Job description

Job Details: Job Location: Central Clinic - Laredo, TX 78041, Position Type: Full Time, DESCRIPTION: To provide eligibility and enrollment assistance following the criteria set by the state programs which includes documentation, problem solving, determination of eligibility and accessibility to uninsured patients of the Center and community residents. Coordinates program services with providers, medical support staff, and community partners.

ESSENTIAL FUNCTIONS:

• Provide application for eligibility and renewal assistance in state program by providing fair, impartial, and accurate information.
• Interviews clients to gather case management information, determines eligibility for medical or social services and appropriately refers to other agencies as needed.
• Provide information and assistance in the applicants preferred language and or provide limited-English proficiency applicants with oral and written notices of their rights to receive language assistance services and how to obtain such services.
• Evaluates information from interview to identify client’s need or problem.
• Maintains clients' records by reviewing case notes; logging events, progress, and posting of service coordination and navigation charges.
• Advises client or client’s relatives, if the case so merits, in formulating a service plan, explaining departmental functions and procedures. Describing feasibility and consequences of alternatives per provider recommendations.
• Ability to work in a variety of settings with culturally-diverse families and communities with the ability to be culturally sensitive and appropriate.
• Composes narrative reports, summarizing case activity and recommends further action as needed, as per provider recommendations.
• Assists patients in obtaining community assistance and/or referral.
• Ensures timely follow-up appointment with providers, of abnormal results and/or condition as per protocol or procedure.
• Ability to work independently with strong sense of focus, task-oriented, nonjudgmental, open personal qualities, clear sense of boundaries.
• Compiles, copy, and completes data for administrative reports, and other documents.
• Maintains and updates patient logs.
• Develops, maintains, and updates the department’s filing system.
• Participates in educational & promotional activities as requested.
• Participate in regular staff meetings, staff training programs, supervisory sessions, and accept the responsibility for aiding the development of positive team relationships as requested.
• Maintains customer confidence and protects operations by keeping information confidential, and adheres to HIPAA Regulations.
• Adhere to agency policy, procedures and the professional code of ethics.
• Maintains operations by following program policies & procedures.
• Contributes to team effort by accomplishing related results as needed.
• Performs other duties as assigned

SECONDAY FUNCTIONS:

• Enters customer and account data by inputting alphabetic and numeric information on keyboard or optical scanner according to screen format.
• Maintains data entry requirements by following data program techniques and procedures
• Receives, reviews, and prioritizes correspondence.
• Participates in educational and promotional activities as requested.
• Compiles, copy, and completes data for administrative reports, and other documents.
• Develops, maintains, and updates the department’s filing system.
• Keeps moderately complex records, to assemble and organize data, and prepares reports from such records.
• Reviews and electronically transmits claims, closes the day, compiles and prints daily reports.
• Maintains a log of all electronically and hardcopy (paper) filed claims.
• Responsible for downloading and printing Remittance and Status Reports or EOBs.
• Posts payments for all claims to patient’s account as per R&S or EOB.
• Runs receipts report to verify that all payments are posted by site and that the check amount reconciles with the computer total.
• Reviews, corrects and appeals rejected claims and answers any associated correspondence from the claim processing.
• Researches and resolves outstanding claims and payment issues for billing and resubmits claims accordingly or initiating the appeal process if needed.
• Investigates all denied claims by rejection code and acts accordingly to file appeals on rejected claims.
• Ability to view clinical data to fulfill responsibilities.
• Responsible to generate monthly reports for all payments received from services rendered by Center providers.

Qualifications: MINIMUM QUALIFICATIONS:

• Must be a graduate from an accredited high school or GED program.
• Two years’ experience preferably in a community health care setting.
• Bilingual in English and Spanish is preferred.
• Possess means of transportation.
• Valid Texas Driver’s License and minimum liability insurance.

SKILLS AND ABILITIES:

• Knowledge of corporate, Federal, State, and Joint Commission requirements/regulations.
• Basic knowledge of Bureau of Primary Health Care and Texas Department of State Health Services, expectations, rules and regulations.
• Ability to interpret, understand and carry out instructions and orders.
• Must be able to establish and maintain good working relationships with co-workers, visitors and patients.
• Must possess basic knowledge of compliance and HIPAA.
• Ability to accept supervision and direction.
• Ability to understand and communicate effectively both oral and written instructions.
• Ability to work effectively with others and to deal tactfully with professional personnel as well as with the public.
• Ability to work with individuals or in a group to promote community education client participation.
• Ability to express ideas clearly and problems or concerns, and also the ability to exercise good judgment in evaluating situations and in making recommendations.