At Boston Children's Hospital, the quality of our care - and our inclusive hospital working environment - lies in the diversity of our people. With patients from local communities and 160 countries around the world, we're committed to reflecting the spectrum of their cultures, while opening doors of opportunity for our team. Here, different talents pursue common goals. Voices are heard and ideas are shared. Join us, and discover how your unique contributions can change lives. Yours included.
The Senior Patient Administrative Coordinator will be responsible for:
Managing the authorization process for a significant variety of medicines, specialized treatments, 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 contact and subject matter expert for obtaining and responding to additional requests for prior authorizations across supported clinical area
Answering, screening and routing a high volume of phone and email inquiries from patients, families and external companies
Responding to patient's concerns and needs within score of knowledge and authority, and 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. Communicating with other departments to coordinate ancillary services
Participating in the development of training programs to update staff on processes as it relates to prior authorizations
Training, orienting and cross-training clinic staff in department systems, processes and terminology
Serving as resource on clinic/service operations and procedures, payer and billing requirements
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 year 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
Please note: During a public health emergency, individuals in this role may be expected to take on additional duties to respond to organizational needs.
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.
Boston Children's Hospital is an Equal Opportunity / Affirmative Action Employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, national origin, sex, sexual orientation, gender identity, protected veteran status or disability.
Internal Number: 3112382
About Boston Children's Hospital
Boston Children's Hospital is a 395-bed comprehensive center for pediatric health care. As one of the largest pediatric medical centers in the United States, Children's offers a complete range of health care services for children from birth through 21 years of age.