Senior Healthcare Navigator
About Eden Health
Eden Health is a nationally recognized medical practice on a mission to create a world where every person has a relationship with a trusted healthcare provider. Working with employers across the country, Eden Health offers employees 24/7 digital care, same-day in-person primary care, mental health services, physical therapy, and benefits navigation. The Eden Health team is driven by a patient-centric approach, delivering relationship-based collaborative care. With this model, our clients have healthier workforces, increased productivity, and reduced healthcare costs. We are committed to diversity, equity, and integrity, and our teams reflect this. Our hope at Eden Health is to create an environment where each person can do the best and most important work in their careers.
What you will be doing
As a Senior Healthcare Navigator, you will have front-line access to ensuring a best-in-class concierge experience for our patients. You’ll be responsible for training new Healthcare Navigators and being a go-to resource for troubleshooting their issues. You will be handling patient requests through our patient facing app, e-mail, and phone. You’ll be expected to complete tasks efficiently and effectively while meeting our SLAs and maintaining high patient satisfaction. You will drive a high-touch patient experience by navigating them through the complexities of healthcare and exceeding expectations by going above and beyond during every patient interaction. You will be researching and connecting them with high-quality, in-network specialists, coordinating their appointments, requesting and releasing medical records, answering questions about their benefits and insurance plans, and resolving billing issues. As a Senior Healthcare Navigator, you will be working closely with our medical providers and Virtual Navigators and report into the Manager, Member Experience.
This is a full time, fully remote position which requires flexibility in working hours. The shifts vary within the windows of 8am-8pm EST, Monday through Friday. In the future, team coverage will be expanded to cover weekends and the Sr. Healthcare Navigator will be expected to assist with shift coverage during this time.
What success looks like
- Efficiently responding to incoming insurance navigation inquiries on a day to day basis with a commitment to hospitality, patient-centeredness, and excellence
- Communicating with patients and third parties in adherence with Eden Health’s customer service standards and style guide and using clear, concise, and professional language
- Engaging with insurance companies and external provider offices and billing teams to fulfill our patients’ requests
- Accurately documenting details of calls and steps taken to complete tasks
- Providing timely communication and updates to patients
- Proactively answering patients’ questions and providing information before they ask for it
- Collaborating with other team members (including Healthcare Navigators, Virtual Navigators, and providers)
- Identifying opportunities for improving our workflows and resources
- Escalating immediately any cases with any patient dissatisfaction or complaint to relevant team members to ensure the continuous improvement of the patient experience
- Driving consistency and alignment in processes and workflow across your teammates
- Training, mentoring, and coaching other Healthcare Navigators
- Creating and maintaining insurance navigation training resources and documentation
- Celebrating insurance navigation success stories and learning from patient feedback, thinking about each patient interaction as an opportunity for continuous improvement
- Handling escalated or sensitive patient cases
- Providing Tier 1 support to your peers and other colleagues within the Eden team
- Assist with leading daily huddles and other team meetings
- Recognize, react to, and report out on trends impacting patients & the team
- Act as a change champion within the team
What you will bring
- 5+ years of experience in a Customer Service role
- 5+ years of experience in a Healthcare role, directly interacting with insurance companies and billing parties a must (claims, complex benefits, appeals)
- 2+ years of experience as a team lead or training and onboarding others
- Advanced understanding of claims processing procedures, from either a provider or payer perspective
- Advanced knowledge of complex benefits
- Ability to work within the hours of 8am-8pm EST
- An obsession with delivering the highest quality customer experience and going above and beyond for customers
- A strong growth mindset with a desire to improve continuously & relentlessly
- An interest in using technology to deliver tech enabled insurance navigation
- Excellent verbal and written communication skills
- Ability to create and update training materials and onboarding plans
- A positive, professional, and empathetic tone with patients and team members
- The desire to be part of a fast-moving startup
- Humor, humility and openness to being profusely appreciated as a hero by our patients
- Ability to adapt to new information quickly
- Solid understanding of healthcare and insurance information and jargon (and ability to deliver complicated insurance information clearly)
- Comfortable working independently and being part of a remote, distributed team
- Spanish speaking and writing fluency a plus
Why Eden Health?
- Remote first company and culture
- Series C Healthtech startup with a mission-driven team that's passionate about helping every person have a relationship with a trusted healthcare provider
- Competitive salary and equity compensation package
- Medical, dental, and vision insurance and commuter benefits
- Dedicated Culture Committee led by CEO
- Learning and development budgets to help you grow and bond with your team
- Positive, inclusive, supportive culture cheering you on your journey
- Strong and quickly growing client base of America’s leading employers
Eden Health is an equal opportunity employer and encourages all applicants from every background and life experience without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.
Please note: Eden Health interview requests and job offers only originate from edenhealth.com email addresses (e.g. jsmith@edenhealth.com). Eden Health will never ask for bank information (e.g. account and routing number), social security numbers, passwords, or other sensitive information to be delivered via email. If you receive a scam email or wish to report a security issue involving Eden Health, please notify us at: security@edenhealth.com.