The Role of Patient Navigators in Helping Clients Make Better Healthcare Choices

Navigating the healthcare industry can be a headache, especially for patients who can’t find the right diagnosis and treatment option for their health condition. This is where patient navigators come in. Their main role is to handle the administrative tasks of patient care.

Patient advocacy is becoming a hot career these days. Their services range from handling medical bills, insurance claims, billing mistakes, and physician referrals. Some agencies provide patient advocacy foundation sponsorships to increase donations and financial support.

In this article, we’ll talk about the role of patient navigators in the medical system and how they help clients make better healthcare choices.

What patient navigators do

Navigators primarily guide patients throughout the complexities of the healthcare industry. This may include helping them to coordinate with healthcare providers, decide on the right treatment option, find the right physicians, and take charge of administrative tasks, such as reviewing medical bills and insurance claims for completeness and accuracy.

Those who wish to enter this profession may consider taking a bachelor’s or associate’s degree in a medical-related discipline, such as nursing, medical assisting, and medical record administrative. A background in patient advocacy will help them understand a variety of diagnoses and treatments for different age groups, such as child care and eldercare. They also need to have a lot of patience and be people-oriented to become effective service providers.

Navigators who want to help patients in terms of billing and insurance aspects should understand how payment systems work, such as co-pays, deductibles, co-insurance, and payer reimbursements.

Other responsibilities include communicating with health insurance firms, accompanying patients to medical appointments or during hospital confinement, identifying care issues, helping patients find doctors, acting as a support person for patients, and monitoring payments.

Patient navigators are also required to have good communication skills, excellent time management, the ability to emphasize, organizational skills, and the ability to get along with people, including patients, professionals, and families. More importantly, they need to be assertive and command respect from people involved in their patient’s care.

Patient Navigator

Job opportunities for patient navigators

Beyond the hospital setting, job opportunities for patient navigators are blooming. They aren’t limited to one work setting since plenty of places offer their services.

Insurance companies: There are insurance companies that hire navigators to assist patients with complex medical cases. They are also called “case managers” or “patient advocates.” Their main role is to help patients save money and guide them throughout the insurance claim process.

Healthcare facilities: Hospitals, rehab centers, and patient-focused firms employ navigators for customer-service positions. They usually require a background in healthcare, insurance, customer service, social work, and treatment advocacy. When solving issues for patients, their decisions often favor the facility and not the patient’s best interest.

Government agencies: Patient navigators work for state-run health systems, particularly in nursing, human resources, or social work capacity. Their primary job is to assist patients who rely on Medicaid, Medicare, and other state-run programs and help them get the most of the services they’re involved with.

Private patient care advocate: There are many rewarding opportunities for starting a private patient advocate business. You can be a self-employed entrepreneur, but you have to learn additional skills and attributes to run a successful business. These include marketing your own services, bringing in more clients, and managing a business simultaneously.

In this type of advocacy setup, the patient or the family member is the employer. They may hire a patient navigator to represent them through medical, legal situations, or insurance claims. Since they work directly for the patient, the navigator should focus on the patient’s best interest.

When working for individual patients, the main job of a navigator is to help them get diagnosed and find the best treatment option. They usually work on insurance-related issues to help their clients navigate the payment system and find possible payment resources. Family members can also hire them if they can’t directly supervise a sick loved one.

Patient navigators can also work as volunteers or bedside advocates. Their role is to be someone’s helping hand and assist them during appointments. Their compensation lies in their satisfaction from helping their loved ones and friends.

The bottom line

Anyone passionate about promoting patients’ rights should consider being a patient navigator. There are a lot of emerging opportunities out there to give you a fulfilling career while having the chance to advocate for patients’ rights in various settings. It all begins with having relevant healthcare experience and a passion for helping patients receive the care they need.