Senior Patient Administrative Coordinator

• Authorizations:
  • Managing the authorization process for a significant variety of medicines, specialized treatments, medical procedures, etc. for patients across multiple providers and specialties. Preparing letters of medical necessity based on physician notes.
  • Under supervision, coordinating with insurance companies, specialty pharmacies and patient families for delivery of specialized treatments during clinic visits.
  • Coordinating appeals with clinicians and patient families by preparing letters of appeal or connecting the clinician directly with the insurance company.
  • Serving as a point of contract and subject matter expert on the process for obtaining and responding to additional requests for prior authorizations across supported clinical area.
• Patient Encounters:
  • Answering, screening and routing a high volume of phone and email inquiries from patients, families and external companies in coordination of services. Recording and forwarding messages and triages calls to clinical staff for urgent information or services. Initiating calls for emergency services as required.
  • Responding to patient’s concerns and needs within score of knowledge and authority. Responding to situations requiring escalated service response.
  • Scheduling patient encounters and procedures to coordinate across providers in multiple specialties. Verifying patient demographics, insurance/payment and referral information.
  • Collecting and organizing medical records, information, materials and supplies required for admissions or encounters. Preparing requisitions and other standard forms as requested by clinician or supervisor. Communicating with other departments to coordinate ancillary clinical/administrative services.
• Training:
  • Participating in the development of training programs to update staff on department/hospital processes particularly as it relates to prior authorizations.
  • Training, orienting and cross-training clinic staff in department systems, processes and terminology.
  • Demonstrating high-level problem resolution skills.
  • Serving as resource on clinic/service operations and procedures, payer and billing requirements.
• Process Improvement:
  • Actively participating in and contributing to departmental and organizational initiatives and projects with a focus on continuous process improvement.
  • Recommending and assisting in implementing change in internal systems and procedures.

To qualify, you must have:

• High school diploma required. Some college or occupationally-specific education/training preferred.
• Minimum of 2 years of experience in a high volume administrative role with an emphasis on problem resolution among multiple internal and/or external parties. At least 1 of the 2 years should be in a healthcare or health insurance setting working with the prior authorization process.
• Strong organizational skills and attention to detail.
• An ability to manage multiple tasks within time constraints, as well as the ability to solve problems but with a keen sense of when to escalate for appropriate resolution.

Boston Children’s Hospital offers competitive compensation and unmatched benefits, including affordable health, vision and dental insurance, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition Reimbursement, cell phone plan discounts and discounted rates on T-passes (50% off). Discover your best