Sr Patient Administrative Coordinator (OPH - Contact Lens Program)
Boston Children's Hospital
Location: Waltham, Massachusetts
Internal Number: 64981BR
Job Summary This Senior Patient Administrative Coordinator will be responsible for:
Managing Prior Authorization (PA) process for contact lens patients; may also train on more complex PA processes in support of specialized medical devices - such as low vision or binocular vision training devices.
Preparing letters of medical necessity as needed based on physician notes.
Serving as point of contact on the process for obtaining and responding to additional requests for PA for medicines/medical devices across relevant insurance companies for supported clinical area.
Accurately creating and compiling bills for contact lenses (private insurance, MassHealth, and self-pay) and submitting to billing department as needed.
Answering phone and email inquiries from patients, families, and external companies in coordination of clinical services. Recording and forwarding messages, pertinent information, as needed.
Scheduling New and Return Contact Lens visits as needed
Verifying patient demographics, collecting all necessary clinical documentation and information
Responding to patient concerns and needs within scope of knowledge and authority and in accordance with best practices and procedures.
Responding to situations requiring escalated service response, ensuring the appropriate providers and parties across multiple specialty areas are made aware of concerns and follows up to ensure resolution
Ordering and maintaining supplies of designated contact lenses and low vision devices.
Reconciling statements from vendors with shipped orders.
Confirming lens orders for specific patients and verifies that contact lenses are available for return visits as needed.
Maintaining organized tracking system of all orders and their status.
To qualify, you must have:
High school diploma. 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.
Experience with medical billing preferred.
Strong organizational skills and attention to detail.
An ability to manage multiple tasks within tight time constraints.
Ability to solve problems but with a keen sense of when to escalate for appropriate resolution.
Probable Schedule: Monday - Friday 8:30a - 5:00p.
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 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.