Care Access Navigator

About Vitra Health

Vitra Health is a mission-driven healthcare organization committed to improving the quality of life for individuals and families across Massachusetts. Through innovative home- and community-based services, Vitra supports aging adults, people with disabilities, and individuals with complex care needs— supported by a Nurse, and Case Manager, Vitra ensures clients receive compassionate, personalized, and dignified care.

To help share our mission and expand our community impact, Vitra Health is seeking a Care Access Navigator who is passionate about community engagement and helping people access the care and resources they deserve.

The Opportunity

The Care Access Navigator is a brand ambassador responsible for preparing and obtaining documentation needed for insurance prior authorization, continuity of care, and maintaining our consumers on their program. This administrative role supports Vitra Health's commitment to excellent healthcare delivery and growth. The members of this team are cross trained in various administrative tasks, and the workflow reflects the daily needs of our consumers.

Key Responsibilities

• Obtain a working knowledge of Vitra Health program offerings and operational workflows.
• Request and maintain medical documentation from healthcare providers, including progress notes, imaging studies, and other necessary medical reports.
• Compile and review documentation from internal and external sources and complete necessary follow-up to ensure consumers continued program enrollment.
• Verify insurance and submit requests for services to a variety of insurance providers according to individual processes.
• Communicate effectively with multidisciplinary care teams, healthcare providers, and insurance companies regarding medical documentation and prior authorization requirements.
• Keep accurate records and update patient files with all necessary patient, provider, and insurance information.
• Provide excellent customer service by expediting and prioritizing requests based on a variety of factors .
• Triage incoming faxes and direct to the appropriate team member or patient chart.
• Maintain detailed documentation related to consumers, providers, and relevant workflows.
• Support the department with administrative tasks including answering phones, directing calls, email correspondence, photocopying, sending faxes, scanning, filing, etc.
• Escalate client concerns and/or progress concerns to management as necessary.
• Maintain the highest standard of confidentiality for all protected health information.
• Serves as a brand ambassador for Vitra reflecting our vision, mission, and values.
• Shows a genuine interest and compassion for the communities we serve and commitment to the diversity of our clients and team members.
• Mentor and supports team members.
• Complete other tasks as assigned.
• Fosters a culture of customer service and commitment to quality care
• Serves as a brand ambassador for Vitra reflecting our vision, mission, and values
• Shows a genuine interest and compassion for the communities we serve and commitment to the diversity of our clients and team members

• Mentor and supports team members
• Complete other tasks as assigned

What we are looking for:

• High school diploma/GED is required.
• 2+ years prior experience with high-volume record processing is required, preferably in the healthcare industry.
• 2+ years' experience and complete comfort using Microsoft Suite.
• Excellent problem-solving, customer service, and communication skills required.
• Prior experience with Hubspot, Salesforce, Optum, Wellsky, RingCentral or similar platforms preferred.

Work Environment and Physical Requirements

• Office-based work in a clean well-lit environment with fluctuating temperatures near others.
• Client-facing field staff and community liaisons require frequent travel to client homes or community settings; ability to drive safely; work in client homes may involve varying temperatures, odors, allergens, pets, and other environmental factors.
• Requires substantial periods of repetitive work utilizing a computer, monitor, keyboard, and mouse.
• Requires lifting and carrying equipment and supplies weighing up to 35 pounds; requires pushing and pulling equipment and supplies weighing up to 35 pounds; requires walking and standing; requires frequent sitting more than 75% of the workday; requires the ability to negotiate stairs; requires visual acuity and manual dexterity to operate equipment.

Perks and Benefits:

• Employer sponsored health Insurance with a generous employer match.
• Dental and Vision Benefits.
• Supplemental Benefits
• Life, Accident, Critical Illness and Disability Insurance.
• 401K with a 5% company match.
• Accrued Paid-Time-Off.
• Ten company paid holidays.
• Wellness Benefits.
• Tuition Reimbursement.
• Supportive team structure and company culture with a focus on work/life balance.

Vitra Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.