Navigation Center Representative (WHWC)

Position Summary

This role serves as a key point of contact for patients across multiple clinic locations, handling high-volume calls and coordinating appointments for medical, dental, and behavioral health services. The position requires strong communication, critical thinking, and multitasking skills to support patient access, resolve scheduling issues, and ensure accurate documentation in electronic health systems. The role also involves collaborating with clinical teams, managing patient inquiries, and providing culturally sensitive service while maintaining compliance with HIPAA and clinic policies.

Scope and Impact

Supports multi-site operations by managing high call volumes, enabling access to critical healthcare services, ensuring effective patient flow, accurate documentation, and positive patient experiences.

Decision-Making Authority

Expected to use sound judgment and critical thinking to triage patient needs, resolve scheduling conflicts, and escalate complex issues to supervisors as needed.

Interactions / Working Relationships

Daily interaction with patients, clinical and administrative staff, and external transportation vendors. Must maintain professional communication and cultural sensitivity.

Essential Duties and Responsibilities

Respond to high-volume inbound/outbound calls for MHM's multiple locations.

Apply critical thinking and sound judgment to interpret patient needs and direct to appropriate services.

Support scheduling for medical, dental, behavioral health, and referrals per guidelines.

Maintain patient confidentiality and ensure HIPAA compliance.

Perform chart checks and ensure accurate documentation.

Coordinate with clinical staff to support patient experience.

Address patient inquiries and escalate as needed.

Monitor and respond to internal communications promptly.

Support No-Show policy process.

Educate patients on clinical policies and procedures.

Collaborate to resolve scheduling conflicts.

Provide community resources on service eligibility.

Document patient interactions in EPM, EHR, and EDR systems.

Coordinate non-emergency medical transportation.

Follow emergency protocols for urgent patient concerns.

Assist with call queue management and performance metrics.

Deliver culturally sensitive service and arrange interpretation.

Support special projects and other duties as assigned.

Supervisory or Leadership Responsibilities

This position does not have direct supervisory responsibilities.

Qualifications

Minimum Qualifications (Required)

Education: High school diploma or equivalent required. Licenses/Certifications: None required. Experience: Minimum one year of call center experience required. Other Required Skills/Knowledge: Knowledge of medical, dental, and behavioral health terminology preferred. Proficiency in Microsoft Office and medical management software is preferred.

Preferred Qualifications

- Bilingual Spanish preferred. - Experience in high-volume healthcare environments. - Familiarity with community resources and patient navigation.

Knowledge, Skills, and Abilities (KSAs)

- Strong interpersonal, organizational, and multitasking skills. - Excellent verbal and written communication abilities. - Ability to maintain professionalism and confidentiality. - Strong judgment to prioritize patient needs and manage scheduling conflicts.

Language Skills

Fluent in English. Spanish bilingual required. Ability to effectively communicate with patients, staff, and other stakeholders.

Technology and Tools

Working knowledge of Internet, Outlook, PowerPoint, Word, and Excel. Experience with Electronic Health Records systems is required.

Work Environment and Physical Demands

Work is performed in a medical and dental office environment with direct patient interaction. Requires ability to bend, sit or stand for extended periods, and manage fast-paced workflows.

Methodist Healthcare Ministries of South Texas