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Care Access Navigator

Job Description - Care Access Navigator


Position Overview

The Care Access Navigator is responsible for preparing and obtaining documentation required for insurance prior authorizations, ensuring continuity of care, and helping clients maintain eligibility for services. This administrative role plays a key part in supporting high-quality healthcare delivery. Team members are cross-trained across multiple administrative functions, with daily responsibilities driven by the needs of the clients they serve.

Key Responsibilities



  • Develop a strong understanding of the organization's programs and operational workflows.

  • Request, obtain, and maintain medical documentation from healthcare providers, including progress notes, imaging reports, and other clinical records.

  • Review and compile documentation from internal and external sources to ensure continued program eligibility.

  • Verify insurance coverage and submit authorization requests according to payer requirements.

  • Communicate with healthcare providers, insurance companies, and multidisciplinary care teams regarding documentation and authorization needs.

  • Maintain accurate client records and update patient, provider, and insurance information.

  • Prioritize and expedite requests while providing exceptional customer service.

  • Process and triage incoming faxes, directing them to the appropriate team member or patient record.

  • Maintain detailed documentation of client interactions and workflows.

  • Provide general administrative support, including answering phones, managing email correspondence, scanning, filing, photocopying, and faxing.

  • Escalate client concerns or workflow issues to management when appropriate.

  • Maintain strict confidentiality of protected health information (HIPAA compliance).

  • Represent the organization professionally and uphold its mission and values.

  • Demonstrate compassion and respect for the diverse communities served.

  • Mentor and support fellow team members as needed.

  • Assist with additional administrative projects and responsibilities as assigned.

Work Environment



  • Office-based role in a collaborative healthcare environment.

  • Extensive computer work, including frequent use of a keyboard, mouse, and monitor.

  • Primarily seated throughout the workday with occasional standing, walking, lifting, carrying, pushing, or pulling up to 35 pounds.

  • May occasionally require navigating stairs.


Requirements


Qualifications



  • 2+ years of experience processing high volumes of records, preferably in a healthcare setting.

  • 2+ years of experience using Microsoft Office Suite.

  • Excellent organizational, problem-solving, customer service, and communication skills.

  • Experience with platforms such as HubSpot, Salesforce, Optum, WellSky, RingCentral, or similar systems is preferred.






Benefits






Benefits



  • Competitive health insurance with generous employer contributions.

  • Dental and vision coverage.

  • Supplemental insurance options.

  • Life, accident, critical illness, and disability insurance.

  • 401(k) with company match.

  • Paid time off and company-paid holidays.

  • Wellness benefits.

  • Tuition reimbursement.

  • Supportive team environment with a strong emphasis on work-life balance.















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