Which key operational knowledge areas must a PES understand to effectively act as a navigator for issues like insurance problems?
Insurance processes, basic health assessments, and administrative workflows, including tracking pre-authorizations.
Success as a Patient Engagement Specialist requires more than just interpersonal skills; deep operational knowledge of the healthcare system labyrinth is necessary. This understanding enables the specialist to effectively streamline administrative processes for the patient. Specifically, they must be conversant with insurance procedures, understand the basics of administering health assessments, and comprehend the standard administrative workflows within the clinic. This expertise allows them to function as a true navigator, tracking down complex issues such as obtaining necessary pre-authorizations for treatments or resolving complications arising from billing discrepancies.
